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AWARD MADE AT THE THIRTEENTH ANNUAL MEETING 


OF THE 


American Public Health Association 


WASHINGTON, D. C., DEC. Io, 1885 


WITH AN APPENDIX 


Concord, NH. H. 


REPUBLICAN PREssS ASSOCIATION, 22 NORTH MAIN STREET 


1886 


pa 
Pans 


¥ 
i) 


2B 4 
f 


INTRODUCTION. 


The four valuable papers which constitute this volume are the result 
of prizes offered by Mr. Henry Lomb, of Rochester, N. Y., through the 
American Public Health Association, for the best essays on the four sub- 
jects presented. This volume has been prepared for the express purpose 
of placing the essays in a form suitable for public and private libraries, 
with a comprehensive index. The essays have also been printed in 
pamphlet form, as will be seen by reference to the advertisement on the 
last pages of this work. 

That these essays may be placed in the hands of every family in the 
country is the earnest desire of the Association, as well as the heartfelt 
wish of the public-spirited and philanthropic citizen whose unpretentious 
generosity and unselfish devotion to the interests of humanity have given 
us these essays; but the financial inability of the Association renders it 
impossible to distribute them gratuitously ; therefore, a price covering 
the cost has been placed upon these publications. It is to be hoped, 
however, that government departments, state and local boards of health, 
sanitary and benevolent associations, etc., will either publish these essays, 
or purchase editions at cost of the Association, for distribution among 
the people. 

Although a copyright has been placed upon these essays for legitimate 
protection, permission to publish under certain conditions can be obtained 


by addressing the Secretary. 


TABLE OF CONTENTS. 


i. Heattuy Homes AND FooD FOR THE WORKING CLASSES. By Vicror C. 
VaucuHan, M.D., Pu. D., Professor in University of Michigan = eats i 


Il. Tue SANITARY CONDITIONS AND NECESSITIES OF SCHOOL-HOUSES AND 
ScHoot-LirE. By D. F. Lincon, M. D., Boston, Mass. . , 5 | hat a ia 


IIL DIsInFECTION AND INDIVIDUAL PROPHYLAXIS AGAINST INFECTIOUS DIs- 
EASES. By GEORGE M. STERNBERG, M. D., Major and Surgeon U.S. Army. 10% 


TV. PREVENTABLE CAUSES OF DISEASE, INJURY, AND DEATH IN AMERICAN 
MANUFACTORIES AND WORKSHOPS, AND THE BEST MEANS AND APPLIANCES 
FOR PREVENTING AND AVOIDING THEM. By GEORGE H. IRELAND, Spring- 
field, Mass. . ; : : ; . : : ° A . : Sis Urars 


V. APPENDIX. lke aye : . . . . rare ry = ee . - 155 


HEALTHY HOMES AND FOODS FOR THE WORKING 
| CLASSES. 


By VICTOR C. VAUGHAN, M.D., Pu. D., 
Professor in University of Michigan. 


HE WHO SECURES A HEALTHY HOME AND HEALTHY FOOD FOR HIMSELF 
AND FAMILY DOES NOT LIVE IN VAIN. 


; 


Copyright, 1886, 


Br Davin A, Wars, Sic, Aamncae Pose Haan J 


Fr 


I, 


BUILDING A HOME. 
LOCATION. 


‘The location of the home of the working-man is often determined by 
considerations over which he has no control. Cost of land and distance 
from place of labor must influence the selection. If possible, however, 
the house should not be located in a low, damp place, nor on made 
earth. In cities, many low tracts, and even the beds of small streams, 
marshes, and lakes, are filled in with general refuse, such as street 
sweepings, back-yard rubbish, ashes, and garbage. Such soil, unless 
thoroughly under-drained, must be unfit for the location of habitations. 
It is damp, and will for years be filled with the products of decomposi- 
tion arising from the putrefaction of the garbage deposited there. Houses 
built in such locations must be damp, musty, and unhealthful. The 
inmates of a house built in such a place are likely to suffer from malaria, 
bilious fever, and rheumatism, even if they do not fall victims to the 
more dreaded diseases, typhoid fever and consumption. The house 
should also be far from marshes and other low lands, whose surface is 
covered with water in the spring and early summer, and then exposed 
later. Such situations are likely to be malarious. Neither should the 
home be located near manufacturing establishments which usually have 
much garbage about them, such as breweries, tanneries, glucose facto- 
ries, rendering houses, and oil refineries. 

The site should be one which is naturally well drained ; and whether 
this be the case or not often cannot be decided in cities without consult- 
ing maps which show the original lay of the land before any grading 
had been resorted to, though the position and course of neighboring 
streams and the location of springs may suggest valuable information. 
The slope of the land should be from the house. Extra precaution must 
be taken when it becomes necessary to build at the foot of a hill which is 
covered with houses from which the surface water and under-ground 
drainage flows toward the home. The location of neighbors’ out-houses, 
with reference to the proposed home, should also be taken into consid- 
eration. While an intelligent man will not neglect the sanitary condition 
of his own premises, his neighbor’s cesspool or privy vault may drain 
into his well and poison his drinking-water. Have the house upon a 
place high enough, and as dry as possible. Avoid, whenever practica- 
ble, narrow streets, which are devoid of sufficient sunlight and pure air. 
The width of the street should be twice the height of the houses along 


4 BUILDING A HOME. 


it, and no street, even in the business centres of cities, should be narrower 
than the height of the houses. In many of the older cities, however, the 
streets are narrower than this. 

The best soils upon which to build are gravel, marl, and limestone ; 
for in these the drainage is likely to be better than in others. 

A due amount of shade around the home renders it more healthy, but 
the shade should not be dense enough or close enough to the house to 
obstruct the air and light. 


THE CELLAR. 


Every dwelling-house, even that which has but one room in it, should 
either have a cellar, or should be raised sufficiently high from the ground 
to allow a free supply of air under it. The walls of the cellar should be 
perfectly water and air tight. It is better, in making the excavation, to 
remove the earth a foot, on all sides, further than the line on which the 
outside of the wall will stand; then, after the walls have been built, pack 
the space with clay or gravel. In this way the walls of the cellar are 
more likely to be kept dry. If built of brick the walls should be hollow, 
consisting of a thin outer wall two or three inches from the main wall. 
The two are firmly held together by occasionally placing a brick across 
from one to the other as the walls are being built. Unless this is done, 
moisture will pass through a brick wall, it matters not how thick it may be. 

The cellar floor should be of concrete, about six inches thick, and 
govered with Portland cement or asphalt. If the soil be very damp, 
tiling should be placed under the cellar floor, and carried out beneath 
the wall to a larger tile which passes around the house and leads off into 
some suitable receptacle. 

It is absolutely essential to a healthy house, that its cellar should be 
free from dampness and ground air. In order to secure these requisites, 
the walls and floor of the cellar must be well built, even if it becomes 
necessary, on account of increased cost, to deprive the superstructure of 
some of its ornamentation. 

The cellar should be well supplied with light by having windows 
above ground, or by sunken areas in front of the windows. The win- 
dow-sashes should be hung on hinges, so that ee may be easily opened 
when the cellar needs an airing. 

If the cellar is to be used for several purposes, as the location of the 
heating apparatus and the storage of fuel and vegetables, it should be 
divided into compartments, the temperature of which may be kept at 
different degrees. 

Basement bed-rooms are almost universally unhealthy, and should be 
used only in cases of absolute necessity. It is also best not to have the 
kitchen in the basement, especially if the room directly above be occu- 
pied. If stationary wash-tubs be placed in the basement, they should 
have a metallic or porcelain lining, and the pipes which conduct the 
refuse water from them should be thoroughly trapped. 


BUILDING A HOME. 5 


THE WALLS. 


If built of brick the walls of the house should be hollow, as described 
in referring to the walls of the cellar. Furthermore, the plastering should 
never be placed directly on the brick. The inside of the wall should be 
*‘furred,” scantling nailed to the furring, and the lathing done as in a 
frame house. It has been found that a single brick will absorb as much 
as one pound of water; and if a brick wall be built solid and the plaster- 
ing placed directly on the brick, the house will be constantly damp. 
Many of the older brick houses are constructed in this manner, and 
consequently their interiors always have a damp, musty odor, it matters 
not how untiring the housekeeper may be in her efforts to have every- 
thing sweet and clean. 

Even in case of a stone wall, the plastering should not be placed 
directly on the wall; though stone does not absorb water to any such 
extent as brick does. 

New brick and stone walls are necessarily damp, and for this reason 
houses built of either should not be occupied until some weeks after the 
building of the walls. In order for them to dry thoroughly they must be 
pervious to air; and walls built as recommended above will allow the air 
to pass through them freely. Plastering does not prevent the air from 
passing through the walls, but papering does. However, as papering is 
the most economical way in which walls can be decorated, it will long 
continue in use. Wal: papers containing arsenical colors have been, and 
are still to some extent, used. Rooms decorated with such papers are 
not suitable for living apartments. Itis generally supposed that only the 
green colors contain arsenic, but, in truth, it may be present in paper of 
any color. The only way, then, by which they may be avoided is by 
having the selected samples tested. Any intelligent druggist or chemist 
will make the analysis for a small fee, which should be at the expense of 
the paper-dealer. | 
_ A nice way of finishing inside walls is to paint and then varnish them. 
The varnish prevents the rubbing off of the paint, and places the walls in 
in such a condition that they may be washed whenever desirable. 


THE FLOORS. 


Floors should be made tight, so that they may be thoroughly scrubbed 
with soap and water occasionally. The best floor, from a sanitary view, 
is one of hard wood, planed smooth, and oiled. It is far better to have 
a clean, bare floor, than one covered with a filthy carpet. However, 
where carpets are kept clean,*and are occasionally taken up and the floor 
scrubbed, there is no objection to their use; and it must be admitted 
that a clean carpet adds much to the comfort of a room. A cheap straw 
matting is now made, which can be washed when necessary, and it will 
not retain dust and filth to the extent that woollen carpets do. Such a 
covering is especially suitable for dining-rooms. 


6 BUILDING A HOME. 


ARRANGEMENT OF ROOMS. 


The living-rooms should be on the sunny, airy side of the house. 
Human beings as well as plants demand sunlight. ‘Too frequently the 
good housewife shuts out the sunlight for fear that it will fade the carpet. 
As some one has said, ‘‘It is far better to have faded carpets than to have 
faded cheeks.” A little saving in the color of the carpet is poor econ- 
omy when it is secured at the cost of health. Especially should the room 
occupied by the women and children, who are indoors much of the time, 
be well supplied with light. If there is to be a long, dark hall or pas- 
sage-way in the house, let it be on the side upon which the least sunlight 
falls; and place the living-rooms on the other side. 

It is, unfortunately, the fashion to make bed-rooms small in order to 
have a large sitting-room. Too often the bed-room is a mere recess 
scantily supplied with fresh air. It is better to have a smaller sitting- 
room and a larger bed-room. Even farmers often suffer from diseases 
which are due to an insufficient supply of pure air. This arises from the 
fact that for six or seven hours out of every twenty-four they are shut up 
in small, tight, musty bed-rooms, and are compelled to rebreathe the air 
which they have already once breathed. 

As has been said in discussing the cellar, basement bed-rooms are 
always poorly supplied with fresh air, and are generally damp and musty. 
They should be used only in cases of absolute necessity. Attic bed-rooms 
are cold in winter and hot in summer, and their use also can be excused 
only on the question of dire necessity. 

If the owner of the house can afford it, at least one bed-room should 
contain a grate or fire-place,—for, with every attention to the laws of 
health, there will come times when some member of the family will be 
sick; and the sick-room should be full of cheer. The open fire is cheer- 
‘ful, and serves as an excellent ventilator. Pleasant surroundings often 
aid the doctor’s pills and potions in restoring the patient to health. 

Of course the number and exact arrangement of the rooms will depend 
upon the purse of the owner; but a cottage may be built so as to be as 
healthy as a palace,—and indeed the advantage is often in favor of the 
former, as the more complicated finishings and elaborate furnishings of 
the latter may serve as harbors for dust and filth. 

Space may often be saved by doing away with the conventional long, 
dark hall, and by having the stairs go up from a sitting-room or from a 
smaller vestibule. The long halls are often cold, dark, and dreary. In 
winter they are filled with cold draughts, and in summer they are recep- 
tacles of refuse of various kinds, and at all times they are cheerless. 
They may be necessary in certain houses, but in small homes they are 
neither ornamental nor pleasant. 

It is the ambition of most American housewives to have a parlor, in 
which the most valuable household ornaments are placed, and which 
opens only when some honored guest comes. The small boys of the 
family look upon it as forbidden territory, and too frequently both fresh 


BUILDING A HOME. 7 


air and sunlight are regarded as intruders, and are shut out. The exclu- 
sion of the small boy may be all right, but the air and sunlight should not 
be treated with so much discourtesy. Indeed, they should be considered 
the most honored guests, and should be welcomed even to a place in the 
parlor. © 

Probably the most important room in the house isthe kitchen. Before 
you praise the housekeeping of any woman, visit her kitchen. The par- 
lor may be a beauty, the bed linen may be spotless, the table may be 
covered with decorated china, but if the kitchen be filthy, all is in vain. 
But in order that the kitchen may be kept in good condition, its construc- 
tion must be proper. The floor is best of hard wood or yellow pine; or, 
if these are too expensive, of selected white pine. They should be kept 
bare. : 

At least two windows, one on each side, are desirable. A pantry or 
shelves for setting aside clean cooking utensils and dishes should be at 
hand. If the cellar be used for the storage of vegetables, an inside stair- 
way from the kitchen or pantry should lead down into it. The flour-box 
in the pantry should be so hung that it will close itself. It adds much to 
the comfort of the cook, and to the cleanliness of the walls and ceiling of 
the room, if the stove or range be covered by a hood which conducts the 
vapors arising from the cooking food into a flue in the chimney. 

If the owner can possibly afford it, the house should contain a bath- 
room. In the absence of public water-supply, a force-pump below, a 
cold-water tank in the attic, and a hot-water tank attached to the kitchen 
range will furnish the bath-tub. The-room should be heated either di- 
rectly or from another room, otherwise it would not be used much in 
cold weather. The cost of the bath-room and its supply need not be 
great, while the pleasure and benefit derived from its use will be appre- 
ciated. 

THE WINDOWS. 


The importance of an abundant supply of sunlight has already been 
insisted upon. If possible, every room should have direct light, and not 
be dependent upon that which is diffused through an adjoining room. 
The location of the windows should be such as to give the greatest amount 
of direct sunlight. The windows should extend well towards the ceiling, 
and should be hung so as to lower from the top as well as raise from the 
bottom. 

The window shutters or blinds must be hung in such a manner that 
they are easily opened. In no part of the house should they be kept 
closed during the day. 


HEATING AND VENTILATION. 


It would be wholly out of place to attempt here any elaborate discus- 
sion of the many methods of heating and ventilating buildings now in 
use. Only a few practical statements will be made with reference to 
securing adequate warmth and sufficient fresh air in dwellings. 


8 BUILDING. A HOME. 


The most common methods of heating small residences are by the 
stove, open fire, and hot-air furnaces. The stove is the most econom- 
ical. The open fire is the most enjoyable, and where it is sufficient, the 
most healthy ; but in the Northern states the open fire alone seldom fur- 
nishes enough heat during the coldest months. The hot-air furnace may 
be so constructed as to bea good method, but care must be used in select- 
ing the furnace and arranging for ventilation. 

In small houses the heat is generally supplied by stoves. In rooms 
which are occupied only during a few hours of the day the wood stove 
is sufficient, and, indeed, has certain advantages. The room can be 
quickly heated, and when left, the fire soon dies out, thus saving fuel. 
But where the room is constantly occupied, coal is a more suitable fuel 
than wood. The temperature is more even, and the fire burns more 
slowly. The relative cost of these fuels var ies in different sections. 

The coal stove should have no loose joints through which gases can 
escape. The mica doors should be kept in repair, and the flue must not 
be allowed to clog. The principal gases given off from burning coal are 
carbonic acid gas, carbonic oxide, and sulphurous oxides. ‘The carbonic 
oxide is poisonous when inhaled in any quantity. It produces a sensa- 
tion in the head similar to that which would be caused by a tight band ; 
and in larger amounts it renders persons insensible, and may produce 
death. Itshould be remembered that the carbonic oxide is without odor. 
Whole families have been fatally poisoned with it. Especial care must 
be taken with coal stoves which are used in bed-rooms or in rooms which 
communicate with bed-rooms, as the carbonic oxide may prove fatal to 
persons while sleeping, without waking them. But there is no danger 
if the stove and flue be in proper condition. Makers of wrought iron 
stoves and furnaces will insist that these gases pass readily through cast 
iron, and for this reason their stoves are superior, and free from danger ; 
but a properly constructed and properly managed cast iron stove or fur- 
nace is free from danger, and in many respects is superior to those made 
of wrought iron. Especial attention should be paid to the position of 
dampers in coal stoves at night. } 

One of the greatest objections to the use of stoves is, that in houses in 
which they are used there is generally no attempt at ventilation. How- 
ever, a house heated with stoves may be as well ventilated as any other. 
In houses as ordinarily built, much fresh air will come in through the 
crevices around the doors, windows, and baseboards. But if many oc- 
cupy the room, the amount of fresh air which finds admittance through 
these channels may be insufficient: especially is this likely to be the case 
if the room is partly surrounded by other parts of the building, and con- 
sequently has but a small surface directly exposed to the out-door air. 
Besides, the direct draughts from doors and windows may be so great as 
seriously to affect the health of the inmates, giving them. colds. When 
any of these troubles exist, one of several simple devices may be resorted 
to in order to secure the admission of plenty of fresh air without danger- 
ous draughts. The most common of these devices consists in fitting a 


BUILDING A HOME. 9 


piece of board from four to eight inches wide in the window frame under 
the lower sash. By this means a space is left between the bottom of the 
upper and the top of the lower sash, through which the air enters, and 
the current is thrown upward, striking the ceiling, from which it is dif- 
fused all over the room. Dr. Keen recommends tacking a piece of cloth 
across the lower eight or ten inches of the window frame, then raising 
the lower sash to a greater or less extent, according to the weather. In 
this way two air vents in the window are established, one under the 
lower sash, the current of which is turned upward by the cloth, and the 
other between the upper and lower sash, as when the board is used. 
Through the upper vent it is supposed that some of the foul air will es- 
cape, though the current through this opening is not invariably outward. 

What is known as Maine’s elbow-tube ventilator consists of a board 
placed under a raised sash, as already described. This board carries two 
tubes, about six inches in diameter, which turn upward, and the ends of 
which are supplied with valves by which the amount of in-flowing air 
can be regulated. 

Another method provides for smaller tubes brought through the wall 
and turned upwards into the room. Some favor still another plan, which 
consists in bringing a tube about six inches in diameter through the wall, 
and, possibly, under the floor to the stove, where the tube terminates in 
a sheet-iron jacket placed around the stove, leaving a space of one or two 
inches, and having escapes only at the top of the jacket. The heat of 
the stove will produce a strong current through the pipe, and the incom- 
ing air will be warmed in passing through the jacket. 

By any of the above mentioned devices, abundant facility may be fur- 
nished for the admission of fresh air; but as two bodies cannot occupy 
the same space at the same time, there must be provided some escape for 
the foul air. This should always be attended to in the constru¢tion of the 
house. For every room which is to be heated by a stove, there should be 
two flues, one for the smoke and other gaseous productions of combustion, 
the other for the removal of foul air from the room. ‘The ventilating flue 
must come to the floor, just above which should be a register. When 
there is a fire in the stove, the upper part of the ventilating flue will be 
warmed by the smoke flue, and consequently there will be an upward 
current init. In this way the withdrawal of the foul air is rendered cer- 
tain. It should also be seen, in the construction of the chimney, that the 
inside of this ventilating flue is not left so rough as to impede the flow of 
air through it, and that it is not clogged with mortar or pieces of brick. 
A good draught through the ventilating flue is almost of as much impor- 
tance as the draught of the smoke flue. 

The partition between the smoke and ventilating flues should be of 
brick placed on edge, thus making it as thin as possible, so that the 
upper part of the ventilating flue will be thoroughly heated from the 
smoke flue. By another method the smoke flue may be made of iron 
pipe placed in a large flue, and the space all around the pipe will serve 
as the ventilating flue. IJ have stated that the register in the ventilating 


IO BUILDING A HOME. 


flue should be near the floor. If near the ceiling, as some would have it, 
there would be too great a loss of heat, as the fresh air as soon as heated 
would find its exit. For summer ventilation, the foul air outlet may be 
at or near the ceiling; but such ventilation in 
winter costs too much, and, besides, when it is 
used, great difficulty will often be experienced 
in heating the room. 

With the plan recommended above, there is 
no reason why any room heated with a stove 
may not be so well ventilated that no disagree- 
able odor will be perceptible to the most sen- 
sitive person upon coming in from the outdoor 
air; provided, always, that the room is clean. 

Fig. 1.—F.., floor; §., stove; §. P,, Unfortunately, however, the great majority of 
stove pipe; V. F., ventilating © houses which are heated by stoves are built 
NI a without the slightest provision for ventilation. 
In such houses, fresh air may be introduced according to the methods al- 
ready given; but the escape of the foul air is more difficult to be provided 
for. It may be done, however, as follows: Place a tin or sheet iron 
pipe, of from six to ten inches in diameter, according to the size of the 
room, along the wall behind the stove. The lower end of this pipe ex- 
tends to within a few inches of the floor, and remains open, while the 
upper end passes, by means of an elbow, into the smoke flue below the 
point at which the stove pipe enters, as shown in the accompanying 
Fig 1. The upper end of the ventilating flue may, when the chimney 
begins near the ceiling, terminate in a jacket around the stove pipe, the 
jacket passing into the chimney as here shown in Fig. 2. In all cases 
the ventilating flue is to have air-tight joints. 

With the open fire or grate, the withdrawal of the foul air is all pro- 
vided for, as it will escape up the chimney. The open fire is not so 
economical as the stove; but, when 
sufficient to warm the room, the former 
is, at least as both are ordinarily ar- 
ranged, more healthful. With the 
open fire or grate, much of the heat 
escapes up the chimney; however, 
with the grate this loss of heat can 
be, to a considerable extent, lessened 
by setting the fire-basket well forward. 

When the hot-air furnace is used, 
certain precautions are desirable, both 
for economy and health. In the first 
place, the furnace selected is nearly 
always too small for the extent of heat- 

: ing required of it. When this is the 
case, the fire must be pushed as much as possible in order to keep the 
rooms warm in winter; consequently the air entering the room is oyver- 


Fig. 2. 


BUILDING A HOME. II 


heated, anda produces headache and dulness.. At the same time the fur- 
nace is soon burnt out, and any money saved in the first place by pur- 
chasing the smaller size will have to be expended with an additional 
amount in securing a new furnace. 

The furnace should be thoroughly encased with thick brick walls, to 
prevent great loss of heat by direct radiation in the cellar. The owner of 
the house will be rewarded for his time and trouble if he sees to it that 
this work is well done. | 

The furnace must receive the air which is to be heated directly from 
the out-door air, and not from the cellar. The cold-air duct should be 
perfectly air-tight, so as wholly to prevent the cellar air from entering 
the heating chamber. Wooden air-boxes are not to be recommended 
unless they be carefully lined with some metal. The external opening 
of the cold air box should not be near any cesspool, drain, or other pos- 
sible source of deleterious gases. It should also be protected by a piece 
of wire net. In the cold-air duct, preferably near its external opening, 
should be a sliding valve, by which the amount of air passing to the fur- 
nace can be regulated; but care must be taken that this valve is never 
entirely closed. Probably it would be better to have it made so that 
when pushed in as far as possible it will obstruct only half the area of 
the duct. 

The air chamber in the furnace should be kept supplied with water. 
The hot-air flue should be so arranged that the horizontal ones are not 
more than fourteen or sixteen feet in length, for if the horizontal flues be 
much longer than this, the draught through them will be so slight that 
the rooms will not be warmed, while the rooms supplied with vertical 
pipes will be over-heated. 

The warm-air register in the room should not be placed directly in the 
floor, but in the base-board. If placed in the floor, it soon receives a 
large amount of dust and other refuse. 

With a hot-air furnace properly selected and arranged, the amount of 
warm, fresh air entering the room is sufficient. But before the fresh, 
warm air can enter, the air already present must find an exit. The fol- 
lowing principles may guide us in economically ventilating a room heated 
with a hot-air furnace: 

(1) Bring the fresh air in near the floor. 

(2) Take the foul air out near the floor. 

(3) Create a draught in the foul-air shaft by means of heat. 

Unless the air already in the room has some means of exit, it will be 
found utterly impossible to heat the room with the warm-air furnace. 
Then it will be seen that both the heating and ventilation depend largely 
upon the withdrawal of the foul air. If the foul air register be near the 
ceiling, much of the warm air from the furnace will escape: directly into 
the foul-air shaft. If there be an open fire in the room, the foul air will 
find a ready exit through the chimney. If there be only a ventilating 
flue, it should be in the same chimney with some other flue which is 
heated, at least in its upper half. Thus a number of ventilating flues 


12 BUILDING A HOME. 


from as many rooms may be placed in the same chimney with, and 
arranged about, the smoke flue of the furnace. Often we find that one 
ventilating flue is expected to do service for a room on the first floor, and 
also for another directly over it on the second. The result frequently is, 
that the foul air of the lower room passes into the room above. ‘There 
should be a separate ventilating flue for each room. 


WATER-SUPPLY. 


It is of the greatest importance to the family that its supply of drinking- 
water be of unquestionable purity. That such dreaded diseases as 
cholera, typhoid fever, scarlet fever, diphtheria, and dysentery may be 
spread by impure drinking-water, there can now be no question. 

The sources of drinking-water may be divided into the following 
classes : 

(1) Cistern water. 

(2) Surface water. 

(3) Subterranean water. 

Cistern water is that which is collected upon the roof of a house, and 
stored in a reservoir known as a cistern, or in a tank, which is usually 


placed in the attic of the house. Cisterns, or underground reservoirs, . 


are more generally used than tanks. 

The condition of this kind of water will be influenced by the air through 
which it falls, by the nature of the roof, and by the kind of cistern, and 
the care exercised in keeping the roof and cistern clean. 

In large cities, especially where there is much manufacturing done, 
there is always a considerable amount of dust and other impurities in the 
air, much of which is brought down with the rains. ‘The conductors 
leading from the roof to the cistern should be supplied with means for 
turning off the first part of the rain-fall. In this way the impurities taken 
from the air and those collected on the roof are disposed of. Especially 
is this desirable if the roof be of wood and old, if there be a collection of 
leaves and other dédrzs from projecting branches of trees, and if there be 
any chance of birds depositing their excrement upon the roof. Probably 
the cleanest roofing material is slate; but its cost has prevented its gen- 
eral use in the construction of residences. 

The cistern should be built of brick, and plastered water-tight upon the 
outstde as well as upon the inside. Strict attention should be paid to 
this, and the walls should be so built as to prevent the possibility of water 
from the adjacent soil passing into the cistern. 

The top of the cistern should be well covered, so as to prevent small 
animals as well as vegetable refuse from falling in. The best covering 
would be a box built up several feet above the ground, and covered with 
fine wire netting. In this way the fresh air will pass down, and the 
space above the surface of the water will be ventilated. When this can- 
not be used, a tight covering of stone, or of wood, if all boards are re- 
moved and replaced by new ones at the first sign of decay, may be used. 


BUILDING A HOME. 13 


A wooden pump should not be placed in the cistern, as it soon decays, 
becomes covered with moss, and collects upon it much filth. An iron 
pipe with the pump in the kitchen is probably the best arrangement. 
However, the cistern should never be built under the house. When so 
built the air above the water is invariably bad, and the periodical clean- 
ing out of the cistern, which should be done once a year at least, is not 
so likely to be attended to. 

It is customary in some places to place near the top of the cistern an 
over-flow pipe which leads into a cesspool or privy-vault. This prac- 
tice has, without doubt, cost many lives. There should not under any 
circumstances be any connection between the cistern and any receptacle 
of filth. ‘This over-flow pipe is often untrapped, or the trap becomes 
defective, and the gases arising from the decomposing matter of the cess- 
pool and privy-vault pass into the cistern. Indeed, cases are known 
where not only the gas, but fluid refuse, has thus been poured into the 
cistern. 

However much care may be taken with the cistern,—and the above sug- 
gestions should be deemed of imperative importance,—the cistern water 
should be filtered before used. Many cheap and effective household 
filters are made, and it is not necessary to go into detail concerning their 
construction ; but a few practical hints may be given as to their care. A 
filter which is kept constantly under water soon becomes utterly worth- 
less. The charcoal box should be frequently exposed to air, and, if pos- 
sible, to direct sunlight. A filter removes suspended matter, and, on 
account of the air condensed in the pores of the charcoal, destroys to a 
certain extent the organic matter held in solution in the water. If any 
epidemic disease prevail at the time, it is always safest to boil any and 
all water used for drinking purposes. Cistern water may be boiled and 
then filtered. If one has no regular filter, it will be better at all times to 
boil the water, after which it may be allowed to run through a piece of 
filter paper, which can be obtained for a trifle at any drug store, placed 
in a tin or glass funnel. When filter paper is used, a new piece should 
be placed in the funnel each day. 

The purity of surface water will depend on the condition of the soil 
upon which it falls and over which it flows, as well as upon the air 
through which it falls. Water which falls upon and flows over a filthy 
soil should not be used for drinking. Since the amount of refuse on the 
surface of the earth is usually greater in thickly settled countries, the 
water collected on such sheds is unfit for use. That there is a certain 
degree of purification in running streams there can be no doubt; but not- 
withstanding this, specific poisons have been carried long distances in 
rivers, and have still manifested their poisonous effects. 

When any serious epidemic prevails, and surface water constitutes the 
drinking supply, it should always be boiled. In India, the spread of 
cholera is often along the water-courses into which excrement from the 
sick and the bodies of the dead are often cast. ‘Typhoid fever and dys- 
entery are also often spread by the use of surface water. 


14 BUILDING A HOME. 


The water collected in shallow wells is really surface water, and that 
often of the worst kind. ‘The use of drinking-water from shallow wells 
is, as a rule, to be condemned. Many people think if water percolates 
through a few feet of soil, every harmful substance is removed. No 
greater mistake could possibly be made. Indeed, by percolation through 
the soil, the impurity of the water is often increased. Various kinds of 
filth which have accumulated upon and within the soil are dissolved in 
the water and carried into the well. Often we find in a small back yard 
a cesspool, privy-vault, and well, all in close proximity. If the well be 
a shallow one, such an arrangement is probably the worst, in a sanitary 
sense, that could possibly be devised. 

Subterranean waters used for drinking purposes are those obtained 
from springs and deep wells. Whether such waters are pure or not de- 
pends largely upon the genealogical formations in which they exist. The 
source of the water must be below rock or thick clay beds in order for 
the water to escape surface contaminations. Springs from gravel hills 
may be as impure as shallow wells. A very small amount of iron in 
water does not render it unfit for drinking; but water which contains 
more than one tenth of one per cent. of iron is unfit for constant use. 

Deep wells should have their walls so protected as not to permit of sur- 
face water finding its way through them. If this is not the case, their 
waters may become quite as foul as those of shallow wells. 

Subterranean waters are often hard. By this is meant that they fail 
to make a lather with soap, or a large amount of soap must be used with 
them in order to produce a lather. The hardness of water is due to the 
presence of certain inorganic salts, as those of lime and magnesia, which 
form insoluble compounds with soap. Hard waters are divided into 
two classes : 

(1) Those whose hardness is removed by boiling. This is known as 
temporary hardness. 

(2) Those whose hardness is not removed by boiling. This is known 
as permanent hardness. 

Many waters possess both a temporary and permanent hardness. 
Such waters are improved by boiling, but are not rendered wholly 
soft. 

Hard waters are not suitable for laundry purposes, especially when the 
hardness is largely permanent. ‘They also often form incrustations in 
boilers. But unless the hardness be very great, it does not unfit the 
water for drinking purposes. There has been much discussion as to the 
possibility of hard waters producing goitre. It is well known that this 
disease is very prevalent in certain limestone districts ; but that the use of 
hard water for drinking is the cause of the disease has not been positively 
demonstrated. It would be best, however, for families in which a ten- 
dency to goitre prevails to use soft water. 

Hard water has also been supposed to favor the formation of gravel. 
The writer has met with a few persons who are troubled with gravel only 
when using hard water. 


BUILDING A HOME. I5 


Some hard waters have an irritating effect upon the bowels of those 
not accustomed to their use, producing in such persons diarrheeas. 

In case of the use of a public water-supply, it is the duty of the health 
authorities of the city to see that the water is wholesome, and it is the 
duty of the consumer to see that the water is not contaminated on his 
premises. Lead pipes and lead lined storage tanks should not be used 
for conveying or storing cistern water. The pipes should be of iron, or 
better still, of block tin, or should be lined with tin. 


THE DISPOSAL OF WASTE. 


One of the most important questions connected with modern sanitation 
is as to the best methods of disposing of waste matter. When allowed 
to accumulate in the vicinity of homes, it may poison both the water and 
the air. Many of the older cities of southern Europe have become thor- 
oughly saturated with filth, and for this reason cholera has found a fertile 
field for its growth in Spain, Italy, and southern France. Filth and dis- 
ease always go hand in hand, the former leading the latter. Cleanliness 
invariably lessens the death-rate. Typhoid fever, cholera, and other dis- 
eases, whose growth and spread are plainly due to the accumulation and 
putrefaction of waste matter, should be stamped out of existence. With 
perfect cleanliness they would not be known. 

It is the writer’s object to give here some practical suggestions for the 
disposal of waste matter. Probably the disposal of human excrement 
deserves more care than any other waste. In cities where there is an 
abundant public supply of water, and where sewers are in use, the water- 
closet is the most convenient method, and it may be made perfectly safe. 
Where water-closets are used, the so-called ‘‘ separate system” of sewer- 
age is desirable. ‘This system provides two sets of sewer conductors. 
One of these is the ordinary brick sewer, and this system is used only 
for carrying off the storm-water. The other is made of small sewer 
pipes which convey the sewage proper, and which are connected with 
flushing tanks, by means of which they are periodically flooded with 
water and washed clean. The advantage of this method is easily under- 
stood. When the single system is used, the sewers are necessarily large, 
in order to carry off the great amount of rain-water. The bottom and 
sides of these sewers must be more or less rough, and they are flushed 
only at the time of heavy rain-falls ; consequently much of the time the 
flow of sewage through them is slow, and the solid matter is deposited 
on the rough surfaces, where it decomposes with the formation of nox- 
ious gases, which escape through ventilators into the street, or pass 
through defective traps into the houses. 

With the separate system the small sewer pipes with smooth inner sur- 
faces are flushed three or four times a day, and their contents are swept 
out. It requires twenty-four hours at least for human excreta to decom- 
pose to such an extent as to evolve poisonous gases; therefore, if the 
pipes be flushed clean one or more times during the day, there can be 
but little danger from ‘‘sewer gas.” 


16 BUILDING A HOME. 


However, whichever system of sewerage is in use, the individual 
should take certain precautions in arranging his water-closets. In the 
first place, water-closets should not be placed in living-rooms or in bed- 
rooms. ‘They should be located if possible in some detached part of the 
house. The kind of closet selected should be determined upon by some 
competent person. Changes and improvements in the patterns are being 
constantly made, so that should any preference be given at this time it 
might not hold good three months hence. The flushing tank for the 
water-closet should not in any way be connected with the drinking water- 
supply. ‘The closet should be well trapped, and the trap should be so 
placed that it can be examined at any time without tearing up the floor 
or breaking into the wall. - The habit which plumbers have of hiding all 
their work should be condemned. The soil pipe should not be connected 
at any point inside of the house, at least with the other waste pipes, such 
as those from the bath-tub and stationary wash-bowls. ‘The soil pipe 
should be ventilated by a pipe which should be as nearly perpendicular 
as possible, and which should extend above the roof of the house, and 
should not be placed neara window. This ventilation of the soil pipe is 
of the utmost importance, and should never be neglected. 

When there is no system of sewerage, the dry-earth closet is the best 
method of disposing of human excrement. Indeed, upon sanitary grounds 
the dry-earth system is in many respects more desirable than the use of 
water-closets ; but the former requires possibly more care than the latter. 
Economically, also, the dry-earth system will prove the better when it 
comes into more general use, and the excrement is used as a fertilizer. 
A dry-earth closet properly kept is free from all noxious gases, and there 
is no possibility of the drinking water-supply becoming contaminated 
from it. 

There are many patterns of dry-earth closets in use, but the simplest 
may be made as efficient as the most complicated and costly. A cheap 
form is made by placing under the seat boxes or drawers lined with gal- 
vanized iron. There is placed conveniently a quantity of dry earth, and 
for each evacuation a small shovel of the earth, from one to two pounds, 
is thrown in. When the drawers are full they are removed, emptied, 
and replaced. ‘The best earth to use is pulverized clay mixed with about 
one third its weight of loam. Ordinary garden soil may be used, if dried 
perfectly. Sifted coal ashes are almost or quite as good as any earth. 
Moreover, they are generally on hand, and to be disposed of in some 
way. The writer has used for his family a dry-earth closet for three 
years, and prefers the sifted coal ashes to any kind of earth. Gravel is 
not at all suitable. 

With an ordinary family with not more than half a dozen members it 
is not necessary to empty the boxes more than once in three or four 
weeks. Their contents, which if enough soil or ashes has been added, 
is wholly inodorous, and may be emptied upon the garden. Here it is 
spaded in during the spring, and as a fertilizer amply repays for the time 
and trouble that has been taken with it. Several large cities in Europe 


BUILDING A HOME. EF 


have adopted the dry-earth system, and the waste is removed by those 
who desire to use it as a fertilizer. 

The patent earth-closets are so arranged that the requisite amount of 
earth falls into the box in a manner similar to that by which the water- 
closet is flushed with water. 

In case epidemics of any kind are prevailing in the neighborhood, it 
would be well to throw a handful of chloride of lime into the closet each 
day. And even when no epidemic prevails, but the weather is very hot, 
the same quantity of sulphate of iron (copperas) may be used daily. 
The cost of this substance is so small that it may be used freely when 
needed. Where many are using the closet, a vault may be dug beneath 
the seat, and made water-tight with brick and cement. Into this should 
be thrown each day a sufficient quantity of this dry earth, and the vault 
should be thoroughly cleaned at least once a month. 

The ordinary privy-vault with porous walls is an abomination. It has 
caused more deaths in this country than war and famine have produced. 
The liquid poisons from it filter into wells, while its gaseous exhalations 
float through the air. People breathe and drink their own excretions, 
and typhoid fever and kindred diseases slay tens of thousands annually. 
It is safe to say that the privy-vault is the origin of the majority of the 
cases of typhoid fever. As the country becomes more thickly settled, 
the dangers from the privy-vault increase, and they should be wholly 
abandoned. 

In many places it is the custom to move the privy, and cover the 
contents of the vault with a few shovels of dirt as soon as the vault is 
filled. In this way from one to half a dozen repositories of filth are 
formed in the average village back yard in a few years. Such a condi- 
tion is certainly a highly unsanitary one. 

The waste-pipes from the bath-tub and stationary wash-bowls should 
be well trapped, with the traps where they can be readily examined ; 
and, as has been stated, these waste-pipes should have no connection, 
inside of the house at least, with the pipe from the water-closet. In the 
absence of sewage, the waste-pipes from the bath and bowls may be 
conducted into a cesspool. Ifthe soil be gravelly, this cesspool should 
be lower than the bottom of the cistern, if the cistern be near. Its walls 
may be of stone or brick loosely laid, and a ventilating pipe should pass 
from the top of the cesspool, and extend at least ten feet above the sur- 
face. No kitchen or laundry waste should be allowed to pass into this 
cesspool. Since the water passing into this cesspool comes only from 
the bath and wash-bowls, it does not contain a great deal of organic mat- 
ter, and will pass into the soil. The cesspool for the kitchen slops should 
be walled up and made water-tight. This cesspool should also be ven- 
tilated by means of a large vertical pipe. The top of this cesspool 
should have a man-hole in its centre, covered with a stone or iron slab, 
which can be removed in order to clean out the cesspool. 

It is better for all pipes leading to sewers or cesspools to be discon- 
nected, or furnished with gulley traps or with an air pipe just outside of 


18 BUILDING A HOME. 


the house, in order to prevent the possibility of gas passing from the 
sewer or cesspool into the house. All cesspools should be as far from 
the house as possible, and they should be cleaned at regular intervals. 
The contents of the kitchen cesspool may be used for fertilizing. 

All solid kitchen waste should be removed daily by a scavenger, who 
does this without expense to the householder, or it may be dried under the 
kitchen stove in shallow pans and then burned in the kitchen fire, or, if 
in the country, it may be fed to hogs or other animals. 

The dust swept from the floor should be burned, not thrown out into 
the yard. Ashes should be kept in a dry place, and if so kept they may 
often be disposed of without cost. The soap-maker will pay for dry 
wood ashes, and coal ashes are often sought for and used for filling in 
- low places. Each fire-place and grate should be furnished with an ash- 
pit in which the winter’s product may fall, and by which accident from 
fire is greatly lessened. 

When a house is built, a plan of all its drainage pipes should be made 
and preserved, as with it a faulty pipe or joint may often be found with 
ease, when without it much work may be necessary in order to find where 
the trouble is. 


THE SURROUNDINGS. 


It would be better if residences were not built up in solid blocks. 
Even narrow passage-ways between the houses, through which the air 
can move freely, are to be preferred to unbroken blocks. However, the 
price of land and of building material may compel some in the larger 
cities to deny themselves any further separation from their neighbor than 
that afforded by a single brick wall. But under no censideration should 
residences be built back to back, without any open space between the 
kitchens of the two houses. Even a few feet of open yard are of great 
benefit in affording ventilation, and in preventing excessive dampness. 
The yard should be kept scrupulously clean, and it should be rendered 
as beautiful as circumstances will permit. In summer there is no place 
for children in their play preferable to a nice spot out of doors. 

The arrangement of cesspools, wells, cisterns, and out-houses has 
already been discussed. None of these should be allowed to contam- 
inate the soil or air of the yard. ‘Trees not too dense or too near the 
house are beneficial in shutting off dust, and tempering the heat of the 
summer’s sun. Besides, no other ornament about the premises can be 
more attractive than beautiful trees. 

The location of all the out-houses of the immediate neighbors, as well 
as those directly on the premises, should be taken into consideration. 
The yard should be so graded that the surface water will not collect about 
the foundations of the house. 

A little care and a trifling expense in the surroundings will amply 
repay any family, and will increase one’s love for what should be the 
dearest spot on earth—home. 


BUILDING A HOME. I9 


THE CARE OF THE HOME. 


Suppose that a location has been selected, a house built, and the sur- 
roundings prepared according to the foregoing directions, the next thing 
is to see that all is kept in a sanitary condition. Some families would 
convert the most scientifically constructed house into a den of filth. 
Cleanliness should be the watchword of every family. So far as san- 
itary needs are concerned, all the directions under this head might be 
condensed into the few words, ‘‘ Keep everything clean.” 

Decaying vegetables must not be leftin the cellar. Fresh air is to be 
admitted daily into every part of the house, from cellar to garret. Bed- 
rooms especially are to be thoroughly aired. Refuse bits of food are not 
to be left to mold on the pantry shelf, nor should they be thrown out into 
the back yard. Better burn them. Offal from the preparation of food is 
not to be allowed to remain in the house, nor is it to be thrown out. It 
must be placed in the swill barrel, or burned. Dirty dishes are not to go 
unwashed, nor filthy floors unscrubbed, nor soiled linen unlaundered. 

Fresh meat, milk, and other foods are not to be allowed to remain 
uncovered in living-rooms or bed-rooms. The flour-box is to be kept 
free, not only from the ravages of rats and mice, but from the dust of the 
room. 

The drain from the ice-box should not be allowed to pass into a cess- 
pool, sewer, or soil-pipe. Indeed, there should be no kind of connection 
between the ice-box, or other place in which food is kept, and any recep- 
tacle of waste matter. 

The floors and seats of water-closets and earth-closets are to be kept 
clean. Drains and cesspools must be attended to. The supply of drink- 
ing-water must be kept free from every contamination. 

Continued health is the reward for the care bestowed upon these 
details. The labor brings a rich return. 


BUYING OR RENTING A HOUSE. 


Great care should be exercised in renting or buying a house for family 
occupation. Many houses are now built purposely to rent or sell, and 
too many of these are constructed in a very flimsy manner. The object 
of the builder is to attract attention to his house, and money is spent in 
ornamentation, which should have been used in the more important parts 
of the structure. No one should place his family in a house until he has 
made a thorough investigation of its sanitary condition. ‘The mere adver- 
tisement that ‘‘the house is furnished with the most approved sanitary 
appliances” should not be considered as a sufficient guaranty. Indeed, 
the statement of the owner or agent, that ‘‘ everything is all right,” is 
usually not to be relied on. The time will come when no one will be 
permitted to rent a death-trap in the shape of a house; but, unfortunately 
at present, the duty of seeing that everything is really all right devolves 


20 BUILDING A HCME. 


upon the person seeking a house. For this reason a few practical direc- 
tions for house inspection may not be out of place here. ‘The writer has 
known a man, even after having been warned by a former tenant, who 
placed his family ina house whose sole recommendation was its attrac- 
tive appearance, and to regret his rashness a few weeks later when 
typhoid fever had stricken his family. The dangers to health and life 
are too great to allow any one to be careless or indifferent in this matter. 

The house offered for rent or sale should be visited by the one seeking 
a home, and thoroughly inspected in regard to its sanitary condition, as 
well as to its general appearance. The surroundings should be studied. 
The condition of the back yard,—especially the location of out-houses 
on the premises and those of the neighbors,—the location and condition 
of cesspools, privy-vaults, cisterns, or wells, if such be present, should 
undergo careful inspection. What the sanitary arrangements should be 
has been already sufficiently indicated. 

The cellar should be visited, and if its walls be cracked, damp, and 
covered with mold, if water stands upon its floor, and if light and ven- 
tilation are not provided for, seek some other habitation. It is better far 
to sleep in the open air, with no roof but the sky and no bed but a few 
blankets placed on the dry earth, than to live in a house built over a 
reeking cesspool; and such a cellar is nothing more nor less than a 
cesspool. 

The general construction of the house should be closely scrutinized. 
Observe the height of the first floor above the level of the street, the pro- 
portion of the lot covered by the house, the arrangement and size of the 
rooms, and the condition of the floors, ceilings, and walls. Of course 
newly constructed walls are always damp. <A great amount of water is 
used in the mortar and plastering, and much of this must evaporate 
before the building is fit for occupation. Neither should a house freshly 
painted with lead paints be occupied until the paint is well dried. The 
living-rooms should be placed upon the sunny, airy side of the house. 
The bed-rooms especially should be examined with reference to their 
size and means of ventilation. ‘The floors should be of seasoned wood, 
well jointed. This is very desirable, as it prevents the accumulation of 
dirt under the floors, and permits of the free use of water in scrubbing 
the upper floors without danger of injury.to the ceilings of the lower 
rooms. 

‘¢ Skin” houses, put up by ‘‘ jerry” builders simply to rent or sell at the 
highest price, can usually be recognized by careful inspection. Extra 
ornamentation will generally be observed, but, if a few months have 
elapsed since its construction, doors will be noticed not to close tightly, 
the wood-work is shrunken, the window-sashes do not move easily, and 
too frequently the foundations have settled and the walls cracked. 

If the house be furnished with any plumbing, this should undergo 
thorough inspection. A map showing the distribution of the pipes, 
unless all are in plain view, should be furnished by the owner. In many 
old houses large brick drains are found in the cellar. These are always 


BUILDING A HOME. 2I 


bad. In them a great quantity of filth accumulates. They are seldom 
sufficiently flushed. Such a condition should lead one to reject a house 
for residence. If the drain in the cellar be of earthen pipe, its joints 
should be examined, for they are often imperfect, and allow of the escape 
of both gaseous and liquid contents. In this way the cellar floor becomes 
impregnated with filth, and from it noxious exhalations rise into the 
rooms above. ‘ The writer has known of more than one instance in 
which one of these drains has been broken by settling, and the conse- 
quence was that a regular cesspool was formed instead of the drain. In 
one instance the break occurred near a cistern, and much of the chamber 
and kitchen slops soaked through the imperfect cistern, polluting the 
water; and this was the probable cause of the typhoid fever which 
attacked four of the inmates of the house. Still worse is the box drain 
made of plank. Often at the junction of the vertical pipe with sucha 
drain, the wood decays, and a filthy cesspool is formed. 

Unfortunately in most cities the sewers pass along the street in front 
of the house, and the sewage is collected in the back part of the cellar, 
and carried by a drain under the floor for the entire length of the cellar, 
passing out under the front wall on its way to the sewer. The best place 
for the sewer is in the rear of the house, but when in front, the drain 
should be carried around the house; or, if through the cellar, it should 
consist of an iron pipe freely exposed along its entire length, and with 
sufficient fall to give a rapid current. Its grade should be uniform, and 
free from depressions in which accumulations might occur. 

The proper arrangement of the soil pipe has already been referred to. 
It should be of iron, not of lead. leaden soil-pipes are often corroded 
and leaky. The ventilation of the soil-pipe should be by means of a 
pipe extending above the roof. The water conductor from the roof 
should not be made to do service as a ventilating pipe. Moreover, 
when the rain-water conductor empties into the soil-pipe the force of the 
current through it will siphon the traps above unless they are all ven- 
tilated. 

The location of all traps should be ascertained, and it should be seen 
that none of the pipes are either clogged or leaky. The desirability of 
the separation of the water-closet from the bath and wash-bowls has 
already been referred to. It is not desirable to have even stationary 
wash-bowls in bed-rooms. 

If there be a water-supply, it is well to see, before renting or buying 
the house, that all the pipes are in good order and so protected that they 
will not freeze. If the drinking-water be stored in a tank, see that the 
tank is not lined with lead. All water pipes should be well supported, 
or they may sag and break. 

The inspection of the method of heating and ventilating the building 
may be made from the rules in regard to these points already given. 
- The same is true in regard to the disposal of garbage and the construc- 
tion of earth-closets. 


22 BUILDING A HOME. 


' TENEMENT-HOUSES. 


Every working-man should strive to secure a home, and the tenement- 
- house can never be a home in any proper sense. The privacy and com- 
fort of a home can never be secured in a tenement-house. Here people 
of all kinds are congregated, and the noise of the boisterous will disturb 
the rest of the quiet; the filth of the slovenly is likely to injure the health 
of those who endeavor to keep everything about them clean; and the 
habits of the immoral are distasteful to the moral. However, on account 
of poverty, many good people are compelled, for a time at least, to 
occupy rooms in a tenement-house. Unfortunately, the majority of such 
houses are built for the purpose of making as large pecuniary return to 
the owner as possible, and he cares but little about the character of his 
tenants or the manner in which they live, so long as their rent is paid. 
In the large tenement-houses of New York, all kinds of occupations are 
carried on, and many of them in the most slovenly manner. 

The tenement should have a cellar under every part of it. The cellar 
should be divided into compartments by brick walls. No part of it 
should be used for sleeping-rooms, and it should be perfectly dry and 
well ventilated. ‘The walls and floors throughout the building should be 
deadened. The halls should be lighted at both ends. They should be 
wide, and the space should not be encroached upon by using them as 
storage rooms. 

Each water-closet should be thoroughly trapped and ventilated by a 
pipe extending above the roof. The ends of these pipes should not have 
return bends, nor be furnished with ca which are likely to obstruct the 
upward current. 

The water-pipes from baths, stationary wash-bowls, laundry tubs, and 
sinks should have no connection with the water-closets, and should dis- 
charge into the open air outside the building over gullies, or should pass 
through air-traps outside of the house, the air-trap having a large ven- 
tilating pipe carried above the roof. In this way there will be no con- 
nection between the drain or sewer and the inside of the house, except 
through the ventilated soil-pipe of a trapped water-closet. 

The floor and seat of every water-closet should be scalded with hot 
water and soap at least twice a week. ‘There should be a separate closet 
for every fifteen persons. 

The laundry work should be done in some special place, and not in the 
living- or sleeping-rooms. The water-supply should be abundant; and 
where the water-closets are used, not less than thirty gallons per day for 
each inmate of the house. Kitchens and bed-rooms should be separate. 
The minimum amount of cubic space allowed should be five hundred 
cubic feet per head, and this amount will answer only when ample pro- 
vision for ventilation exists. 

Each room should be lighted by outside windows or by light-shafts. 
The window sash should lower. from the top as well as raise from the 
bottom. Each room must be furnished with a separate flue for ventila- 


BUILDING A HOME. 23 


tion, or a foul-air shaft, which should be heated. These shafts may be 
heated by being placed in the same chimney with smoke flues, or in case 
the entire building is heated by steam, a number of foul-air shafts may be 
brought together in the attic, and heated by a steam coil. If this is done 
there should be no means of cutting off the steam from this coil. The 
method of removing foul air, by means of a large central shaft, may do 
when there are conductors leading from each room to such a shaft, but 
when it depends upon the foul air from distant rooms reaching the shaft 
by means of open doors or through transoms, it will often fail. More- 
over, all attempts to ventilate a number of rooms on different floors 
through the same flue or shaft, it matters not how large it may be, will 
always prove more or less of a failure; because, on account of difference 
in temperature, the foul air from one room will often pass into another. 


II. 
HEALTHY FOODS. 
FOODS AND FOOD-STUFFS. 


Since particles of our bodies are constantly being worn away and cast 
out, new material must be introduced in order to make good the loss. 
Again: it is necessary that our bodies should be supplied with force or 
energy, that animal heat, muscular movement, and nervous activity may 
be maintained. For these reasons foods are taken. 

Foods may be defined as substances which when taken into the body 
aid in building up or repairing tissue, or, by being oxidized or burned, 
generate force or energy. 

Our ordinary foods consist of certain food-stuffs or elementary princi- 
ples, together with a greater or less amount of wholly indigestible sub- 
stances. ‘Thus, oatmeal is a food containing the food-stuffs, gluten, 
starch, and fat, with a certain amount of cellulose (cell structure) which 
is of no service to the body. The nutritive value of a food depends upon 
the kind and amount of these food-stuffs that it contains. Since no satis- 
factory discussion of foods can be carried on until we become acquainted 
with those constituents upon which their values depend, we will briefly 
consider the food-stuffs. Fortunately they are not numerous, and may 
be divided into the following classes : 

(1) Albumens or proteids. 

(2) Fats or oils 

(3) Starches or carbohydrates. 

(4) Inorganic salts. 

(5) Water. 

Albumens or Proteids. To this group belong some of the most impor- 
tant food-stuffs. They all contain nitrogen, and for this reason the term 
** nitrogenous constituents” is used sometimes instead of proteids or albu- 
mens. The chief proteids are ordinary albumen, as the white of egg, 
casein of milk, fibrine of meat, gluten of grains and flour, and legumine 
of pease andbeans. The amount of proteid in the different foods is varia- 
ble ;—thus, meat contains from 15 to 23 per cent.; milk from 3 to 4; 
pease and beans from 23 to 27; grains and flours from 8 to 11; bread 
from 6 to 9; and potatoes and greens from 1 to 4. 

When we remember that the blood, muscles, and all the vital organs 
contain proteids as their chief constituents, we can understand the impor- 
tance of taking food rich in one or more members of this group. The 
average working-man requires in his daily food the equivalent of four or 
five ounces of pure proteid. 


HEALTHY FOODS. 25 


The digestive and assimulative organs have the power of converting 
one proteid into another, but they are not able to form a proteid out of a 
fat ora starch. For this reason no other food-stufts can, without injury, 
be a substitute for the proteids in our food for any length of time. 

fats. Fats when oxidized or burned in the body produce more force 
than will arise from the combustion of an equal weight of any other food- 
stuff. In cold countries the inhabitants instinctively consume large 
amounts of fat on account of the heat which is generated from it. The 
-working-man requires not less than two ounces of fat per day. Fats are 
best digested when taken in a finely divided state. 

Starches or Carbohydrates. ‘To this group belong a number of sub- 
stances of similar chemical composition, and the majority belong to veg- 
etable foods. The most important are starch, sugar, gum, and dextrine. 

Like the fats, they are consumed in giving energy to the body, though 
a much larger amount of the carbohydrates is required to yield the same 
result to the body. The daily need of this food-stuff by the average 
working man is between seventeen and eighteen ounces. 

The cellulose or cell structure of plants is closely allied to the members 
of this group, and any cellulose that is absorbed must first be converted 
into sugar. | 

Mineral Salts. ‘The bones of the adult man contain as much as 47o 
per cent. of mineral matter, the greater part of which is the phosphate 
of lime. Smaller quantities of the phosphate of magnesium and the car- 
bonate of lime also exist in bones. ‘The muscles, blood, and tissues also 
contain salts of potash and soda, and some iron. One of the most im- 
portant mineral foods is common salt or the chloride of sodium. 

Water. About 7o per cent. of the adult body is water. It forms the 
greater part of the vital fluid, in which it serves as the carrier of other 
substances, some in solution, others held in suspension. Besides the 
fluids, the solid tissues contain a greater or less proportion of water: the 
muscles contain as much as 75 per cent. There is also great loss of 
water by evaporation from the skin, by exhalation from the lungs, and 
by excretion from the kidneys and bowels. This loss must be made 
good by the drinking of water, and by taking foods more or less rich in 
this constituent. Meat contains about 75 per cent. ; milk on an average, 
87; bread, 35; and vegetables and fruits, from 70 to go. 


THE NUTRITIVE VALUE OF FOODS. 


The nutritive value of a food will depend upon the proportion and 
kind of food-stufls which it contains. However, there are many condi- 
tions which influence the nutritive value of a food. In order for this to 
be high, its constituents must not only be rich in food-stuffs, but they 
must be digestible. By improving the digestion, the appearance, odor, 
and taste of a food increase its nutritive value. A certain method of cook- 
ing makes a food more acceptable to one, while another is pleased with 
a wholly different manner of preparation. The taste and odor, when 


26 HEALTHY FOODS. 


pleasing, stimulate the flow of the digestive juices; and not only will 
more of the food be taken asa result, but a greater proportion of that 
which is taken will be digested and assimilated. 

It is also quite essential that the volume of food taken should be large 
enough to satisfy the appetite, and still not so great as to prove burden- 
some. For this reason foods poor in certain food-stuffs are usually taken 
with some other food rich in these constituents. Thus, the potato, which 
contains not more than 2 per cent. of proteids, is usually eaten with 
meat, which contains from 14 to 21 per cent. of proteids; or we may 
say with equal propriety, that because meat contains no starch, man has 
learned to take with it the potato, whose chief constituent is starch. If 
one should attempt to live upon potatoes only, the weight of the food that 
he would have to take each day in order to get the minimum quantity of 
proteids upon which life could be sustained would not be less than ten 
pounds. Dr. Edward Smith actually found some of the poorest Irish 
laborers confined almost exclusively to potatoes, and consuming the 
amount given above. This would lead to distention of the digestive 
organs, and render one dull and stupid. The digestive organs of plant- 
eating animals form from 15 to 20 per cent. of the entire body weight. 
In flesh-eating animals the digestive organs form only from 5 to 6 per 
cent. of the body weight; in man the proportion is from 7 to 8 per cent. 
Thus, man, upon this point at least, holds an intermediate position be- 
tween flesh-eating and plant-eating animals, being more closely allied to 
the former than to the latter. However, as the proper cooking of the 
food aids digestion, man may digest some of the vegetable food even 
more quickly and completely than the ox can. But his food should not 
consist wholly of vegetable products. A certain amount of animal food, 
while not absolutely necessary to the maintenance of life, is essential to 
man’s highest development. 

The nutritive values of the different foods, as shown by the per cent. 
of the various food-stuffs which they contain, will be given under the 
special description of each food. 


THE ECONOMIC VALUE OF FOODS. 


That food is most economical which contains the greatest amount of 
the most valuable food-stuffs for the least money. 

The average working-man requires daily in his food, in round num- 
bers, not less than four ounces of proteids, two ounces of fat, and eighteen 
ounces of carbohydrates. What combination of foods will furnish these 
for the least money? This is an important question; but in answering 
it, it should always be borne in mind that the foods suggested are to be 
healthy ones. A combination which would cost but little, but which 
would lead to dyspepsia or other ills, might in the end be quite costly. 

The following formulas show some combinations, and give the approx- 
imate cost. It will be seen that the required amount, or more, of each 
food-stuff is present : 


HEALTHY FOODS. 


27 


- Cuass I.—Very cheap daily rations without meat. 


26 oz. bread 

2 oz. oatmeal 
I pt. of milk 

I oz. sugar . 
24 0z. potatoes 
40z. beans . 
2 oz. lard 


26 oz. bread 

2 oz. fat cheese 
I pt. milk 

16 oz. potatoes 
4 0z. beans . 

I oz. lard 

I Oz. sugar . 

3 5-0z. Cups tea 


16 oz. bread 

4 0z. oatmeal 

I pt. milk 

I oz. sugar . 
32 Oz. potatoes 
I oz. lard 

5 oz. fat cheese 


160z. bread . 
6 oz. oatmeal 

I pt. milk 

I oz. sugar . 

4 0z. beans . 
32 oz. potatoes 
I oz. lard 


3 5-0z. Cups tea 


NO-AT, 
Proteids. Fats. 
Oz. Oz. 
1.82 0.13 
0.29 0.12 
0.54 0.57 
0.48 
0.92 0.08 
: 1.98 
4.05 2.88 
NG 2. 
1.82 0.13 
0.50 0.58 
0.54 0-57 
0.32 
0.92 0.08 
0.99 
4.10 2.35 
No. 3 
I.12 0.08 
0.58 0.24 
0.54 0-57 
0.64 
O99 
hi28 1.45 
4-13 3°33 
No. 4 
lia 0.08 
0.87 0.36 
0.54 0.57 
0.92 0.08 
0.64 
0.99 
4.09 2.08 


Carbo-hydrates. 


Oz. 
14.35 
1.30 
0.76 
0.94 
4.96 
2.14 


24.45 


Cost. 
Cts. 


5 at 5 cts. per loaf. 

4 at 4 cts. per Ib. 

3 at 6 cts. per qt. 

3 at 8 cts. per lb. 

14 at 60 cts. per bush. 
I at 4 cts. per lb. 

13 at Io cts, per lb. 


12% 


5 at 5 cts. per loaf. 

14 at 12 cts. per lb. 

3 at 6 cts. per qt. 

I at 60 cts. per bushel. 
I at 4 cts. per Ib. 

g at Io cts. per Ib. 

4 at 8 cts. per lb. 

I at75 ‘cts: per Ib: 


os 


138 


3 at 5 cts. per loaf. 

I at 4 cts. per Ib. 

3 at 6 cts. per qt. 

4 at 8 cts. per Ib. 

2 at 60 cts. per bushel. 
8 at Io cts. per Ib. 

Sf atir2 cis perp. 


138 


3, at 5 cts. per loaf. 

14 at 4 cts. per Ib. 

3 at 6 cts. per qt. 

3 at 8 cts. per Ib. 

I at 4 cts. per Ib. 

2 at 60 cts. per bushel. 
# at ro cts. per Ib. 

Rab 7S clsperiy. 


123 


28 HEALTHY FOODS. 


No. 5. 
Proteids. Fats. Carbo-hydrates. Cost. 
OZ. Oz. Oz. Ctsi 
POW TEAC bliss i aliihenits sik Wate Lao Oe OS GTA 5 5 at § cts. per loaf. 
BR, ACE Mite eile clin hee pid Ces”) OT 0.02 1.53 I at 8 cts. per Ib. 
IAD aa Ue AS ee ECs tai a ROG 0.12 14 at 16 cts. per doz. 
Wg SV ALY EVs I GR ae Se CLE a hp 0.99 # at 10 cts. per Ib. 
LACT AR, 6] ha 8 MALI aaa) Nay iad « 0.08 2.14 I at 4 cts. per lb. 
Avoz. tat cheese)... Teo 1.16 0.08 3 at 12 cts. per lb. 
4.02 250) {70.10 11g 
No. 6. 
BOOLIDLCAG Wiite Wie ee So han ie | tne Lee lade ee aii Re Ine 5 at 5 cts. per loaf. 
R/Ox. QNACAYONA «ie Pan se a hO.09 0.76 14 at 20 cts. per Ib. 
AOS EAN ih Cia iulejl tenis aan eur Oe 0.08 2.14 I at 4 cts. per lb. 
B2 OTs DOTALOES i) ute sne pe ea Od 6.62 2 at 60 cts. per bushel. 
POZA ATC Meehan nd sie hae ie 0.99 $ at Io cts. per Ib. 
AOZ) SAU CNeeseh he FAA a RE bE GO 1.16 0.08 3 at 12 cts. per Ib. 
Di OZUSUSAL shy fe ar tue Cnet 0.94 4 at 8 cts. per lb. 
3'S-02, }0UDS Ol tea 0h reins ey I at 75 cts. per lb. 


4-47 2.36 24.89 148 


. 


Although the rations suggested in the preceding tables do not contain 
meat, they do contain more or less animal food, and are healthy. How- 
ever, the writer would not recommend one to adhere constantly to them, 
as some meat, while not necessary to health, does undoubtedly increase 
bodily vigor. 

The small amount of really nutritive matter in tea is not considered, 
and the reader is referred to the articles ‘‘ Tea” and ‘+ Coffee” for a true 
explanation of the food values of these drinks. 

It will be seen that among vegetable foods in common use, oatmeal, 
beans, and potatoes are the cheapest. Since the prices vary so greatly, 
not only at different times, but in different parts of the country at the 
same time, the price at which the computation is made is given in each 
instance ; and if the prevailing price differs from that given, any one can 
ascertain the change that would be produced in the total cost of the daily 


rations. ; 
Ciass I].— Very cheap daily rations with meat. 


No. I. 
Proteids. Fats. Carbo-hydrates. Cost. 
Oz. Oz. Oz. Cts. 

ZOOL DOLRAM WIRY erie! We | Neila coe OLE Sy Ass 5 at 5 cts. per loaf. 
2 OZ OGURID MORNE py fetta) aE OO 0.02 14 at 10 cts. per Ib. 
2 O24 FALE HRN MeN he Mata MieiN eho 1.98 13 at Io cts. per Ib. 
1602; (POtACORS At ed iia ne denis Or32 Riad I at 60 cts. per bushel. 
Tt.) We Aa Seine tye We md, 0.57 0.76 3 at 6 cts. per qt. 
LOZ SUBAT AIAG ie ie yer lie (iiils 0.94 4 at 8 cts. per Ib. 
3 5-02. CUDS RCATnN Joma iel ia I at 75 cts. per Ib. 


A:25 0h i270 aL OL36 13 cts. 


16 oz. bread 

I oz. codfish 

I oz. lard 

32 Oz. potatoes 

2 0z. bacon 

4 0z. beans . 

I pt. milk 

I oz. sugar . 

3 5-ounce cups tea 


26 oz. bread 

2 oz. oatmeal 

I pt. milk 

I oz. sugar . 

2 oz. codfish 

8 oz. potatoes . 
2 oz. lard 

3 5-0z. Cups tea 


26 oz. bread 

I oz. codfish 

2 oz. lard 

6 oz. beans . 

2 oz. fat cheese 
I pt. milk 

I oz. sugar . 

3 5-0z. cups tea 


26 oz. bread 

2 oz. fat cheese 
2 0z. bacon . 

4 0z. beans . 

I pt. milk 

I oz. sugar . 


3 8-oz. cups coffee . 


HEALTHY FOODS. 


29 


No. 2. 
Proteids. Fats. Carbo-hydrates. Cost. 
Oz. Oz. Oz. Cts. 
E12 0.08 8.83 3 at 5 cts. per loaf. 
0.80 0.01 § at 10 cts. per Ib. 
0.99 $ at 10 cts. per lb. 
0.64 6.62 2 at 60 cts. per bushel. 
0.29 0.75 14 at 10 cts. per lb. 
0.92 0.08 2.14 I at 4 cents per lb. 
0.54 0.57 0.76 3 at 6 cts. per qt. 
0.94 4 at 8 cts. per lb. 
I at 75 cts. per lb. 
Ae3to i 24a) 19.29 134 
No. 3. 
1.82 Osa t4.35 5 at 5 cts. per loaf. 
0.29 0.12 1.30 4 at 4 cts. per Ib. 
0.54 0.57 0.76 3 at 6 cts. per qt. 
0.94 fat 8cts. per Ib. 
1.60 0.02 14 at Io cts. per Ib. 
0.16 1.65 4 at 60 cts. per bushel. 
1.98 1, at 10 cts. per Ib. 
I at 75 cts. per lb. 
4.41 2.82 19.00 13 
No. 4. 
1.82 Os rit Ars 5 5 at 5 cts. per loaf. 
0.80 0.01 £ at Io cts. per lb. 
1.98 14 at Io cts. per lb. 
1.38 0.12 3.21 14 at 4 cts. per lb. 
0.50 0.58 0.04 4 at 12 cts. per lb. 
0.54 0.57 0.76 3 at 6 cts. per qt. 
0.94 4 at 8 cts. per lb. 
I at 75 cts. per Ib. 
5.04 3:39 19.30 139 
No. 5. 
1.82 Ot Sia T4235 5 at 5 cts. per loaf. 
0.50 0.58 0.04 14 at 12 cts. per lb. 
0.29 0.75 14 at 12 cts. per Ib. 
0.92 0.08 Ai4 I at 4 cts. per Ib. 
0.54 0.57 0.76 3 at 6 cts. per qt. 
0.94 4 at 8 cts. per lb. 
2 at 27 cts. per lb. 
4.07 2.11+ 18.23 143 


30 HEALTHY FOODS. 


No. 6. 
Proteids. Fats. Carbo-hydrates. Cost. 
Oz. Oz. Oz. tse 

BO IOZOTEAC Ooo Sah tye’ tue Gl eee eye Bers tatdoas 5 at 5 cts. per loaf. 
BROZCOCUSE he tre ik Ww one relate SO 0.02 14 at Io cts. per lb. 
THOZEDAGON Ge Vice SAL Navi a scenes 0:37 # at 12 cts. per lb. 
POLAT MRE bids eu waaely We aoe 1.98 13 at 10 cts. per lb. 
POO DOTALOGS) (> Vz) Wala enh aaa te Sat I at 60 cts. per bushel. 
EATER Sie ites tein ethene whee Anne 0.28 0.38 14 at 6 cts. per qt. 
THOZa SUP AL it, Tate Ne|s 0 Oe ake 0.94 4 at 8 cts. per Ib. 
Si0-02.CUDS CONES |g tan lntiis 2 at 27 cts. per lb. 


oes ee 


4.15 2.78 18.98 134 


Ciass Il].—Moderately cheap daily rations. 


No. I. 
Proteids. Fats. Carbo-hydrates. Cost. 
Oz. Oz. Oz Cts. 

TOOZ Tea aint a eee 0.08 8.83 3 at 5 cts. per loaf. 
SZ. Deel (Very fat) i. re elie gO 2:12 8 at 16 cts. per lb. 
B2OZ i DOLALOES waver bayoee. Y tath ie (HOO ng 6.62 2 at 6o cts. per bushel. 
Oe MARIE fy lle. iin iets tae Wee tO eC) eh 1.01 4 at 4 cts. per lb. 
ok SOP) an a et Co eagle lwp 0.85 1.14 44 at 6 cts. per qt. 
POs OUR AT eee ee (syne Nyce tatie 0.94 4 at 8 cts. per lb. 


ce ee 


4.22 ee he AV ah ee Be 184 


No. 2 
26:02; Dread vu. oi% Be etsy OTs Aca 5 at 5 cts. per loaf. 
8 oz. beef Paoiectely fat). Pees 0.45 9 at 18 cts. per Ib. 
160z. potatoes . . Bin acy 3.31 I at 60 cts. per bushel. 
Goay ny Sy) cahe An) RR PD Cn RIA PIAL #1 6 0.85 1.14 44 at 6 cts. per qt. 
TUOZSOUULES Pe tie Gla a hate | Awe 0.83 14 at 24 cts. per lb. 


4.63 2.20 716160 21 


No. 3 
BOMOZ TEAC yt hris eh tek ealue nal Oe 0,13 14.35 5 at 5 cts. per loaf. 
4 oz, mutton (very fat)». }).0..) 10.60 1.44 4 at 16 cts. per lb. 
AIOZMDEADS | h wiukinine sia aae vie Ate NO Oe 0.08 2.14 I at4 cts. per Ib. 


DPIC p eee Meet ie che nee LO 1.14 Lek? 6 at 6 cts. per qt. 


4.42 2499 t T801 16 


No. 4 
BOOZ. Dread Nie ie sine tal Saal athe D138 21035 5 at 5 cts. per lb. 
8 oz. mutton (moderately Aye 1.36 0.48 9 at 18 cts. per lb. 
29 OZ. DOLALOES Viel et is Tile ie |) sO 6.62 2 at 60 cts. per bushel. 
APs TUS a gate ean eal ge ithe Ope 0.28 0.38 14 at 6 cts. per qt. 
T\OZH SURAT ia aie Ne ee ahiie ew hate 0.94 $ at 8 cts. per lb. 


HEALTHY FOODS. 


Proteids. 
Oz. Oz 
BEURUMEE ows se 1.66 

masoz. cups coflee . . .- . 
4.09 2-55 
No. 5 
20.0z. bread. . 1.82 0.13 
4 oz. pork (lean) . 0.80 0.28 
2 oz. fat cheese 0.50 0.58 
32 oz. potatoes 0.64 
4 pt. milk 0.27 0.28 
I oz. butter . 0.83 
3 8-oz. cups coffee 
4.03 2.10 
No. 6 
MIRC ink ays 6 1282 0.13 
2 Oz. sausage (best quality) 0.57 0.80 
2 oz. oatmeal 0.29 0.12 
40z. beans . 0.92 0.08 
I oz. bacon. 0.14 0.37 
I pt. milk 0.54 0.57 
I oz. butter . 0.83 
I oz. sugar . 
3 5-0z. Cups tea 

4-28 2.90 


Fats. Carboehydrates. 


Oz. 


19.49 


31 
Cost. 
Cts. 
3 at 24 cts. per Ib. 
2 at 27 cts. per lb. 


23 


5 at § cts. per loaf. 

3 at 12 cts. per Ib. 

td at 12 Cts. per lb. 

2 at 60 cts. per bushel. 
14 at 6 cts. per qt. 

14 at 24 cts. per lb. 

2 at 27 cts. per Ib. 


164 


5 at 5 cts. per loaf. 
14 at 12 cts. per Ib. 
4 at 4 cts. per Jb. 

I at 4 cts. per Ib. 

# at 12 cts. per Ib. 
3 at 6 cts. per qt. 
14 at 24 cts. per lb. 
4 at 8 cts. per Ib. 

1 at 75 cts. per lb. 


—y 


142 


Cuiass 1V.—More expensive daily rations. 


No. I. 
Proteids. Fats. Carbo-hydrates. Cost. 
Oz. Oz. Oz. Cts. 
PEeaCa ss... «21.12 0.08.) 8.83 3 at § cts. per loaf. 
2 eggs 0.24 0.24 4 at 24 cts. per doz. 
2 0z. butter. 1.66 4 ac 32 Cts. per Jb. 
I qt. milk 1.08 1.14 52 8 at 8 cts. per qt. 
I oz. bacon 0.14 0.37 # at 12 cts. per lb. 
I oz. string beans . 0.03 0.06 2 at 32 cts. per Ib. 
8 oz. mutton 1.36 0.48 9 at 18 cts. per Ib. 
32 0z. potatoes 0.64 6.62 2 at 60 cts. per bushel 
1 0z. sugar . 0.94 4 at 8 cts. per lb. 
1 oz. dried fruit 0.02 0.55 14 at 20 cts. per Ib. 
4.63 3.97 18.52 348 
NO}; 2: 
160z. bread. 1.12 0.08 8.83 3 at 5 cts. per loaf. 
Eee Oatmeal! .) . ‘.i 0.29 0.12 1.30 % at 4 cts. per lb. 
woz, sugar... . 1.88 I at § cts. per lb. 


ne 


1 pt, milk 

I Oz. macaroni. 
8 oz. beef 

32 oz. potatoes 

2 oz. salmon 

2 oz. butter . 

3 8-0z. cups coffee 


20 OZaDIEAG. ).s!\.-ss1 ve 
40z. beef . 

2 oz. butter. 

2 oz. fat pork 

2 oz. beans 

2 oz. starch . 

20z. sugar . 

2 oz. dried fruit 

8 oz. potatoes . 

8 oz. lean mutton . 
3 8-oz. cups coffee 
4 pt. milk 


20 oz. bread 

2 oz. oatmeal 

I qt. milk 

20z. sugar . 

2 oz. butter. 

2 oz. mackerel . 

8 oz. chicken 

16 oz. potatoes. ....). 


8 oz. fruit (as apple sauce) . 


26 oz. bread 

2 oz. sausage 

2 oz. butter . 

8 oz. lean beef 

16 oz. potatoes 

2 oz. macaroni 

I qt. milk 

2 0z. sugar . 

3 8-oz. cups coffee 


HEALTHY FOODS. 


Fats, Carbo-hydrates. 


Proteids. 
Oz Oz. 
0.54 0.57 
0.09 
1.68 0.44 
0.64 
0.32 O.II 
1.66 
4.68 298 
No. 3 
1.40 0.10 
0.84 0.22 
1.66 
0.29 0.75 
0.46 0.04 
0.05 
0.16 
1.36 0.48 
0.27 0.28 
4.83 3.53 
No. 4. 
1.40 0.10 
0.29 0.12 
1.08 I.14 
1.66 
0.46 0.13 
1.86 0.19 
0.32 
5-41 3-34 
No. 5 
1.82 0.13 
0.57 0.80 
1.66 
1.68 0.08 
0.32 
0.18 
1.08 1.14 
5-65 3.81 


Oz. 
0.76 
0.76 


6.62 


20.15 


11.04 


1.07 
1.67 
1.88 
Tit 


Cost. 
Cis; 


3 at 6 cts. per qt. 

14 at 20 cts. per Ib. 

g at 18 cts. per Ib. 

2 at 60 cts. per bushel. 
14 at 20 cts. per Ib. 

4 at 32 cts. per lb. 

2 at 27 cts. per Ib. 


—— 


274 


4 at 5 cts. per loaf. 
44 at 18 cts. per Ib. 
4 at 32 cts. per lb. 
14 at 12 cts. per lb. 
4 at 4 cts. per lb. 

2 at 16 cts. per Ib. 
I at 8 cts. per Ib. 
24 at 20 cts. per lb. 
4 at 60 cts. per bushel. 
8 at 16 cts. per lb. 
2 at 27 cts. per lb. 
14 at 6 cts. per qt. 


32 


4 at 5 cts. per loaf. 

4 at 4 cts. per Ib. 

6 at 6 cts. per qt. 

1 at 8 cts. per lb. 

4 at 32 cts. per lb. 

14 at 12 cts. per Ib. 
124 at 25 cts. per lb. 

1 at 60 cts. per bushel. 
1 at $1 per bushel. 


313 


5 at 5 cts. per loaf. 

2 at 16 cts. per lb. 

4 at 32 cts. per lb. 

g at 18 cts. per lb. 

I at 60 cts. per bushel. 
24 at 20 cts. per Ib. 

6 at 6 cts. per qt. 

I at 8 cts. per Ib. 

2 at 27 cts. per lb. 


328 


ee 


HEALTHY FOODS. 33 


No. 6. 
Proteids. Fats. Carbo-hydrates, Cost. 
Oz. Oz. Oz. Cts. 
or OO ET a rene ey 273 OTS tA. 35 5 at 5 cts. per loaf. 
Se eee ae eR Le 0.24 4 at 24 cts. per doz. 
0 SS 1.66 4 at 32 cts. per lb. 
Sepammicampeei, .. . - . 1.68 0.08 9 at 18 cts. per lb. 
2 oz. beans Daa 6 wa, O4O 0.04 1.07 4 at 4 cts. per lb. 
NG i a os 9 | 0.37 $ at 12 cts. per lb. 
eommnarmioes | . «wwe 0032 3.30 I at 60 cts. per bushel. 
MONA SG ee ww 0.94 4 at 8 cts. per lb. 


OM kw 0054 0.57 0.76 3 at 6 cts. per qt. 
3 8-oz. cups coffee Ziat\27 cts. per ID. 


5.20 3-091 20.42 294 


To tne cost of the raw food, as given in the preceding tables, is to be 
added the cost of cooking, fuel, keeping the table, and of furnishing sea- 
soning, such as salt, pepper, and mustard. Where six or more persons 
eat together, the cost of the above items, including enough to pay the 
wages of the cook and waiters, is from 35 to 50 cents per week for each 
boarder. ‘This increases the daily cost of board by from 5 to 7 cents 
above the figures given in the tables. 


ANIMAL FOODS. 
MEATS—GENERAL PROPERTIES. 


A large proportion of our daily food consists of material derived from 
the animal world. Other animals take vegetable food and build it up, 
so that it approximates in physical and chemical properties the flesh of 
man. Of the foods thus derived from the animal kingdom, meat is one 
of the most important. Meat consists of different food-stuffs, as water, 
mineral salts, albumen, and fat. On an average, 100 parts of beef consist 
of 72 parts of muscle, 8 parts of fat, and 20 parts of bone (including car- 
tilage and tendon). ‘The age of the animal, and the manner in which it 
has been fitted for market, have a marked effect upon the composition of 
the flesh. Veal contains 3 per cent. more of water, and a corresponding 
amount of solid substance, than lean beef. Fat beef may contain as much 
as 10 per cent. less of water than lean beef. The same is true of the dif- 
ference between mutton and lamb. Of all the kinds of flesh eaten, fat 
bacon contains the least amount of water. The average per cent. of 
water in bacon is 60, while that in lean beef is 75. The flesh of wild 
fowl, chickens, and pigeons furnishes on an average 77 per cent. of water. 
Fish is especially rich in water, the carp yielding 80 per cent. The fat 
in lean beef, veal, and mutton may be as low as from 1 to 14 per cent., 
while that of fat beef is 14, of fat mutton g, veal 6, and bacon 24. Along 
with these variations in the amounts of water and fat there are corre- 
sponding changes in the quantity of nitrogenous material. As a rule, 


34 HEALTHY FOODS. 


fish is poorest in nitrogenous substance, the per cent. in carp and salmon 
being 13, in pickerel 15; fat veal, mutton, and bacon, 15; fat beef, 16; 
lean beef, 22. } 

The following rules may govern us in the selection of meats: 

Good beef has a reddish-brown color, and contains no clots of blood. 
Well nourished beeves furnish a flesh which while raw is marbled with 
spots of white fat; it is firm and compact. Old, lean animals furnish a 
flesh which is tough, dry, and dark; the fat is yellow. Veal is slightly 
reddish, and has tender, white fibres. The fat is not distributed through 
the lean, as in beef. The same is true of mutton. In well nourished 
animals, white fat accumulates along the borders of the muscles. 

Pork is rose-red, and has fat distributed through the muscle. The lard 
is white, and lies in heavy deposit under the skin. The flesh of an old 
boar is dark, and often has an unpleasant odor and taste. 

Good beef is not of a pale pink color, and such a color indicates that 
the animal was diseased. Good beef does not have a dark purple hue, 
for this color is evidence that the animal has not been slaughtered, but 
has died with the blood in its body, or has suffered from some acute feb- 
rile affection. 

Good beef has no, or but little, odor; or if any odor is perceptible it 
is not disagreeable. In judging as to the odor of meat, pass a clean 
knife, which has been dipped in hot water, through it, and examine sub- 
sequently as to the odor of the knife. Tainted meat often gives off a 
plainly perceptible and disagreeable odor while being cooked. 

Good meat is elastic to the touch. Meat that is wet and flabby should 
be discarded. It should not become gelatinous after being keptan a cool 
place for two days, but should remain dry on the surface and firm to the 
touch. 

The flesh of young animals is more tender than that of the adult, put 
experiment, as well as experience, has shown that the former is less easily 
digested. For instance, veal and lamb are less easily digested, and tax 
the stomach of the dyspeptic more than beef and mutton. Dr. Smith 
has shown that this is largely due to the fact that the flesh of young ani- 
mals cannot be perfectly masticated. The tissues of the young animal 
are less stimulating, less nutritious, and more gelatinous than the tissues 
of the adult animal. On the other hand, it is well known that an animal 
may be so old and poorly nourished that its flesh well-nigh defies both 
mastication and digestion. ‘The common breeds of cattle are best fitted 
for the market at the age of 7 years; the better breeds earlier. 

It makes a difference whether the special meat be served in or out of 
season. Beef is in highest season in the early months of winter, after 
the animal has been furnished abundant pasturage, though not absolutely 
out of season at any time of the year. Fresh pork is wholly out of sea- 
son during the hot months of summer. Christison found in salmon, be- 
fore the spawning season, 18.5 per cent. of fat and 39 per cent. of solids ; 
after the spawning season, I per cent. of fat and 20 per cent. of solids. 

In most cases, animals are fattened for the table. Some fat is desira- 


HEALTHY FOODS. 35 


ble, as it renders the meat more juicy, and develops an agreeable flavor. 
But the process of fattening is often carried too far. Fat should be taken 
in a finely divided state, for when swallowed in lumps it is well-nigh 
indigestible. Many a child, which has been reproved for refusing to eat 
fat meat, will readily take the same amount of fat, as butter, spread upon 
bread. The manner in which the animal has been killed affects the 
meat. Slaughtering is usually so conducted as to remove as much as 
possible of the blood. Either death is produced by the withdrawal of 
blood, or the blood is withdrawn as soon as possible after death. The 
removal of the blood enables the meat to be kept with more ease; it also 
improves the flavor. 

In warm countries meat is often cut from the animal and cooked as 
soon as death is produced, and before rzgor mortzs (the stiffness of death) 
setsin. While the rigor is on, the meat is more difficult of mastication 
and digestion. In temperate latitudes the flesh is usually kept until this 
rigidity naturally passes off. This may be aided by pounding the meat 
after it has been cut into thin pieces. With us, the only animals which 
are cooked before rigor sets in are fish, frogs, some mollusks, frequently 
domestic fowls, and sometimes wild game. 

The flesh of wild animals is richer in nitrogen and flavor, and contains 
less fat, than that of the same species kept in domestication. 

Meat which has been frozen decofhposes easily after being thawed out, 
and when cooked it is dry and insipid. 

The ancient Egyptians and Chaldeans were acquainted with the fact 
that the flesh of diseased animals might harmfully affect those eating of 
it, and among them the use of such flesh as food was prohibited. The 
strictest measures were taken to see that the meat furnished their kings 
and priests was obtained from healthy animals. Even during the dark 
ages this prohibition of the use of flesh from diseased animals continued. 
During the eighteenth century, however, it was found that the inhab- 
itants of besieged towns ate of such food when starvation threatened 
them, and without any marked detriment to health. The flesh of a dis- 
eased animal does not necessarily convey the malady to the consumer ; 
but in order to prevent such transmission the cooking must be thorough. 
That phthisis (consumption) may be imparted to dogs by feeding them 
upon tubercular flesh has been proven experimentally. Dr. Livingston 
states that the use of the flesh of animals afflicted with pleuro-pneumonia ° 
produces carbuncle. In Germany and France many cases of anthrax or 
malignant pustule in man have arisen from partaking of the flesh of ani- 
mals with this disease. The flesh of sheep with the small-pox, and of 
oxen with the cattle plague, has affected those partaking of it. Then 
there are the parasites, trichinz, cysticerci (in ‘‘ measly” meat), and 
echino-cocci (flukes), which may be transmitted to man. If every part 
of the meat be raised to a temperature of 160° Fahr. during cooking, 
these parasites are destroyed; but if the blood-red juices exude from the 
interior of the piece of meat on being cut, the parasites, if present, may 
still retain their vitality. 


36 HEALTHY FOODS. 


The eating of the flesh of diseased animals is admissible only when no 
better food can be secured, and when starvation threatens. ‘The sale of 
such meat is prohibited by law, and any one guilty of such an outrage 
should be punished to the fullest extent. 

‘The flesh of a healthy animal may become poisonous from partial 
decomposition. By the putrefaction of albuminous substances, certain 
organic poisons are generated. The symptoms produced resemble those 
of severe cholera morbus, and a fatal termination is not infrequent. 
These cases most frequently arise from eating sausage and canned meats, 
though they may be due to any meat which is partly putrid. 

Gerlach, director of the Royal Veterinary School at Berlin, gives the 
following list of meats which should not be eaten: 

(1) The flesh of all animals which have died of internal diseases, or 
which have been killed while suffering from such diseases, and of healthy 
animals which have been killed by over-driving ; | 

(2) The flesh of animals with contagious diseases which may be trans- 
mitted to man; 

(3) The flesh of animals which have been poisoned ; 

(4) The flesh of animals with severe infectious diseases, such as blood 
poisoning ; 

(5) Flesh which contains parasites that may be transmitted to man ; 

* (6) All putrid flesh. j 


METHODS OF COOKING MEAT. 


In boiling meat, if it is desired to retain the juices, the piece should be 
large, and should be placed at once in boiling water, and the boiling 


continued for five minutes. Then the temperature of the water should — 


be allowed to fall to 160° Fahr., at which point it should be maintained 
until the meat is done. The boiling water coagulates the outside of the 
meat, and thus prevents the escape of the juices. If the temperature be 
kept at or near the boiling point throughout the process, the flesh shrinks, 
becomes tough, loses in flavor, and is finally digested with much diffi- 
culty. 

On the other hand, if the object of the boiling is to make a good soup, 
the meat should be cut into small pieces, placed in cold water, and the 
temperature gradually raised to from 150° to 160° Fahr. Chicken broth 
is the most nutritious ; mutton next ; while beef makes a very weak broth. 
By boiling, meat loses, as a rule, from 25 to 30 per cent. of its weight. 

In roasting, the oven should at first be very hot; then it should be 
cooled down, and the process continued at a low temperature. Since 
the heat applied to every portion of the outside of the meat cannot be so 
uniform in roasting as in boiling, the loss is usually greater in the former 
than in the latter. 

Stewed meat is that roasted in its own juices. The meat is cut into 
small pieces, and the cooking should be carried on at as low a tempera- 
ture as possible. ‘The extracted matter should be served with the meat. 


HEALTHY FOODS. 37 


Often vegetables are stewed with the meat, thus improving the flavor of 
the former. 

Proper cooking renders the meat more agreeable to the senses of sight, 
smell, and taste, and thus through the nervous system it stimulates the 
flow of the digestive fluids. One of the most fruitful sources of error in 
the cooking lies in using too high a temperature. 


BRIEF CONSIDERATION OF THE MEATS IN COMMON USE. 


Beef. Among all civilized people beef is regarded as the principal 
animal food. By common consent we admit that. beef is more nutritious 
than any other kind of flesh. This universal opinion is supported by the 
investigations of science. There is a larger proportion of nutritious 
material in beef than in the flesh of the sheep or hog. Beef is of closer 
texture, and is fuller of red-blood juices. It is richer in flavor than the 
flesh of any other domestic animal, and a smaller amount of it will sat- 
isfy hunger. Siegert gives the following figures, showing the average 
per cent. composition of the flesh taken from different parts of a lean and 
a fat ox: 


Lean Ox. Fat Ox. 
Neck. Sirloin. Shoulder. Neck. Sirloin. Shoulder. 
Water, 77-5 77-4 76.5 735 63.4 50.5 
Fat, 0.9 I.1 $3 5.8 16.7 34.0 
Muscle, 20.4 20.3 Zia 19.5 18.8 14.5 


On an average, 65 per cent. of the live weight of an ox may be con- 
verted into salable meat, the exact proportion varying with the degree 
to which the animal has been fattened. The greater the amount of fat, 
the less the proportion of bone and other waste. 

Not only does beef from different animals differ in composition, flavor, 
and digestibility, but that from various parts of the same animal varies. 
The flesh from the different parts of the carcass is divided into the fol- 
lowing four classes, according to quality: 

Class I. Porterhouse, sirloin, and best cuts from the rump: Price per 
pound, 15 cents. 

Class II. Round, shoulder, ribs, top ribs, flank steak, plate, and skirt, 
12% cents. 

Class III. Best parts of neck, brisket, and flank, 8 cents. 

Class IV. Poorer parts of neck, flank, and brisket, 7 cents. 

Pieces of shank and bone are usually sold by the piece, and not by the 
pound. The prices vary in different sections of the country and at differ- 
ent times, but the writer gives the above figures for the purpose of show- 
ing the difference in value of different parts from the same animal. 

Veal. In many sections of the country calves of all ages are slaugh- 
tered. In some cities, as in Boston, the killing of a calf under one 
month of age for food is prohibited. It would be well if this law, or a 
more extensive one, should be enforced all over the country. Veal is too 
often used simply as a dish to please the taste. As has been remarked, 


38 HEALTHY FOODS. 


it is not nearly so nutritious as beef, and is much more difficult of diges- 
tion. Some persons are wholly unable to digest veal, and when they 
eat of it, it acts as a foreign body in the intestines, and causes griping 
and diarrhea. Dr. Smith states that it is more easy of digestion when 
well roasted or broiled than when boiled. The time required for the 
digestion of veal is five hours or more, while beef is digested in from two 
and a half to three hours. 

The mode of killing often practised in this case has a special influence 
on the nutritive value of the food. Veal is bleached by repeatedly bleed- 
ing the animal for some days, and at last allowing it to bleed to death. 
The bones of calves contain much animal matter, and for this reason 
they are used for the production of gelatine ; and calves’ feet are selected 
for the preparation of jellies, which are often very acceptable to the sick. 

Mutton. This is more easily digested than beef, though in a healthy 
man no marked difference would be observed, since in the stomach of 
such a man there arises no inconvenience from the digestion of beef. 
However, mutton will be found to tax the stomach of the dyspeptic less 
than beef does, and mutton broth is both acceptable and valuable to a 
person suffering from dysentery or kindred affections of the bowels. But 
mutton is not so nutritious as beef. 

In dressing a mutton, the woolly coat should not be allowed to touch 
the flesh. There is quite a perceptible difference in the flavor of mutton 
taken from a fattened wether, which has been for some time deprived of 
all excess in his woolly coat, and of that taken from a sheep which has a 
heavy fleece. The smallest proportion of both fat and bone to muscle is 
found in the leg; consequently this is the most valuable part of the ani- 
mal. 

Lamb. This is not nearly so nutritious as mutton. The tissue is soft, 
gelatinous, and rich in water. It is used principally on account of its 
delicacy of flavor, which, however, is very variable, depending upon the 
breed and nourishment. Lamb should not be selected for those whose 
digestive organs are weak. 

Pork, Bacon, and Ham. Asa rule, dried meats are more difficult of 
digestion than the same meats in the fresh state. Bacon and ham are, 
however, exceptions to this rule, for when well cured they are digested 
with more ease than fresh pork. In cold weather, nice bacon is espe- 
cially suited for furnishing a large amount of heat by its oxidation in the 
body. The inhabitants of cold countries find fatty food necessary to their 
existence. 

For several reasons, the flesh of the hog must continue to form one of 
the most important sources of our food. This animal can be fattened 
more readily and at less cost than either the ox or sheep. The best 
breeds of pigs store up in their bodies three times as much of the food 
which they eat as the ox does. Then the flesh can be cured easily and 
preserved indefinitely. Again, the animal multiplies rapidly and reaches 
maturity speedily. 

On the other hand, of all the meats ordinarily eaten, this is most likely 


HEALTHY FOODS. 39 


to be diseased. ‘‘Measly” pork can, as a rule, be recognized by the 
unaided eye on close inspection. The meat is dotted with grayish-white 
specks, about the size of a pea; but ‘‘ measly” pork is often cut up into 
sausage, in which the diseased condition escapes recognition. The 
*‘measles” (cysticerci), taken into the stomach of man, develop into 
tape worms. Then there are the trichine, which can be recognized only 
by the aid of the microscope. These little parasites penetrate the mus- 
cles of man, causing great suffering, which often terminates in death. 
These parasites occur so frequently in pork and its cured products, that 
every one should always remember that the flesh of the hog should not 
be eaten unless it has been thoroughly cooked. As we have stated, these 
parasites are destroyed if the temperature of every part of the meat be 
raised to 160° Fahr. during cooking. 

Fowl. ‘There is no bird that may not be eaten in case of necessity. 
In other words, the flesh of no bird is in itself poisonous. The same is 
true of the eggs of all birds. It is true that cases of poisoning from eat- 
ing quails, during spring, have occurred; but the poisoning was due to 
the buds of the mountain laurel, upon which the birds fed. The flesh of 
carnivorous birds is strong in odor and in taste, and would not form a 
tempting dish, save to one threatened with starvation. The light meats 
of birds are more easily digested, less rich in nitrogen and in flavor, than 
the dark meats. Chicken broth is more nutritious than that made from 
either mutton or beef, and is often of great value to the sick. 

Fish. Undoubtedly the flesh of some fish is poisonous. A fish is said 
to justify suspicion when it has attained a size unusual for one of its spe- 
cies. ‘This popular idea may have a grain of truth in it. Fish should 
be discarded if the water in which it is being boiled blackens silver. The 
coloration is due to hydrogen sulphide (the gas of bad eggs), and indi- 
cates putrefactive changes. Decomposing fish has a pale look, and its 
belly is bluish. It is withered, sticky to the touch, and foul in odor. 
The seller sometimes tries to hide the evidence of decomposition by 
taking the eyeballs out and coloring the gills with blood. Fish caught 
from putrid water should not be eaten. Sometimes, near large manu- 
facturing establishments where a great deal of refuse is thrown into the 
water, the fish are killed, and may be brought to market. The flesh of 
such fish is yellowish, soft, spongy, and of foul odor. Fish may be 
divided into those furnishing white and those furnishing red meats. 
Those of the former class, as the whitefish, are delicate and easy of diges- 
tion, while those of the second class are richer in nitrogen, and more 
stimulating. Fish should not be left in the water after they are dead, 
but should be packed in ice. 

Fish should not be the chief flesh diet of a people, because it is not 
sufficiently stimulating. Indeed, it is doubtful if any class of people 
would voluntarily confine themselves to such food. 

But the occasional use of fish forms a change which is both agreeable 
and beneficial. There is no truth in the popular idea that a fish diet is 
especially suited to the development of the brain and nervous system. 


40 HEALTHY FOODS. 


Along with fish are often classed certain crustaceans, as the crab and 
lobster, and certain mollusks, as the oyster and mussel. The oyster and 
mussel are gelatinous, but are easily masticated and digested. ‘The lob- 
ster, crayfish, and crab are more muscular, and are somewhat more dif- 
ficult of mastication and digestion. The nutritive value of the oyster is 
not very great, but its delicacy of flavor and ease of digestion make it of 
great value to all, and especially to the sick. The raw oyster is probably 
more easily digested than se cooked. 

The crab and lobster are of considerable nutritive value, though, on 
account of price, they are used principally as delicacies. 

Sausage. The food value of sausage depends upon the substances out 
of which it is prepared. If made from good meat it forms a very valu- 
able preparation, as by this means all the small bits are collected and 
saved. But its method of preparation allows of the introduction of poor 
grades of flesh, and of several adulterations. 

The adulterations which have been found in sausage are meal, to in- 
crease the bulk and the profit; salicylic acid and borax, to prevent 
decomposition ; and a red coloring matter (fuchsin), to give the poorer 
quality of meat a better color. The liver sausage (leberwiirste of the 
Germans) is made by grinding up liver, lungs, kidney, tendon, soft car- 
tilage, and fat; sometimes meal is added. ‘The so-called white sausage, 
which is used to some extent in this country, is made by mixing the 
crumbs of white bread with the meat. Blood or red sausage consists of 
a mixture of blood, fat, and flesh, with or without meal. Pea sausage is 
a well known preparation in France, where it is patented and warranted 
not to become rancid. It is of variable composition, but consists prin- 
cipally of ground pease with meat, and some preservative, as salicylic 
acid. ‘The writer does not know of its introduction into this country. 

Sausage poisoning, which is common and so often fatal in parts of 
Germany, is fortunately very rare in this country, though a similar affec- 
tion from canned and dried meats is becoming too frequent. The poison 
is generated by partial decomposition. Sausage which has a putrid odor, 
or rancid taste, or has greenish or yellow spots in its interior, should 
not be eaten. Bad sausage, and other similar meat preparations, are 
usually, in the interior at least, soft and sticky, and when broken show 
small cavities. This is true even when the outside appears to be all right. 

Meat Extracts. Liebig’s meat extract, which is now so well known, 
is made by boiling lean meat with from eight to ten times its volume of 
water, removing the insoluble parts, fat and albumen, and evaporating 
to the consistency of a syrup. About thirty pounds of meat yield one 
pound of extract. Meat extracts are made on the largest scale in South 
America, from cattle which are wholly worthless for beef. 

it will be seen that this extract consists only of those constituents of 
the meat which are soluble in water, and they are certain crystallizable 
organic bodies and the inorganic salts. All the really nutritive parts 
of the meat are insoluble in water, and are not, therefore, present in 
the extract. Liebig’s extract and similar preparations are agreeable in 


HEALTHY FOODS. 4! 


taste and odor, and are valuble stimulants, often improving the appetite, 
so that more valuable foods are demanded and digested. As stimulants, 
they are of great value to the sick; but some other food should also be 
supplied. A German deprived two dogs of all solid food, giving one 
only water, and the other meat extract. The one furnished with the 
extract lost flesh more rapidly than the other, and died first. 

Beef-Tea. This should be prepared as follows: Cut the beef-steak 
into fine pieces. Put the chopped meat, without any water, into a 
small vessel, which is set into a kettle of warm water. Heat gradually, 
keeping the water in the kettle above blood-heat, but do not allow it to 
boil. Remove the small vessel containing the meat and the juice which 
has exuded from it, strain its contents, season, and serve. 

As thus prepared, beef-tea is somewhat more nutritious than Liebig’s 
extract; still, its chief value is to those who need a stimulant, and to those 
for whom a very small amount of food is sufficient. 

Fluid Meats and Peptones. ‘These are supposed to be formed by 
artificial digestion, whereby the same products are produced as in the 
stomach. ‘The best of them are of value; others are worthless. They 
are to be regarded as medicines, and are to be used according to the 
directions of the physician. 

Bone and Cartilage. Bone consists of a gelatine forming organic sub- 
stance, and of mineral salts. Besides, the marrow contains considerable 
fat and a little albumen. About one third of bone is organic matter, a 
large part of which is soluble in boiling water. For this reason, bone is 
of value in making soups. The long bones are not acted upon by water 
readily, unless they first be cut or ground into small pieces. The bones 
of the spine and the ribs make a very nutritious soup, which yields as 
much as twenty-four per cent. of the weight of the bone in solid matter. 
Bones should be boiled for several hours, in order to get all the food- 
stuffs out of them. When we remember that these soups are also used 
for the purpose of serving vegetables, we may appreciate the real value 
of bone as a source of food. 


MILK.! 


Milk is a white, yellowish white, or bluish white fluid. It consists of 
a colorless fluid holding milk globules in suspension. ‘These globules 
render the fluid opaque. 

The reaction of fresh milk (cows’) is sometimes alkaline, sometimes 
acid; but, as a rule, it gives both reactions, turning blue litmus paper 
red; and red litmus, blue. 

Composition. Milk contains representatives of all the classes of food. 
The albuminous constituents are casein and albumen. ‘The former is 
coagulated when the milk becomes sour, or on the addition of an acid, or 
by the action of rennet. The albumen is precipitated by heat. The 


tAs cow’s milk is the only kind that is used as a commercial food in this country, all the state- 
ments made will refer to this kind unless some other kind be specified. 


42 HEALTHY FOODS. 


amount of casein is much larger than that of albumen. There is also a 
nitrogenous constituent which is not coagulated by either heat or acids. 

The fat of milk forms butter, and the importance of this constituent is 
so great that we often decide as to the value of a given sample of milk 
from the amount of butter which it yields. 

Milk sugar has the same chemical composition as cane sugar; but they 
differ somewhat in their physical properties. 

If some milk be evaporated to dryness and the residue be burned, there 
remains a flaky, white ash, which contains all the inorganic salts which 
are absolutely necessary to the body. 

The following table gives the average per cent. composition of milk: 


Water, Casein and Albumen. Fat. Milk Sugar. Ash. 


87-5 3-5 3-5 4.8 0.7 


Colostrum. The fluid which the cow yields directly after calving is 
known as colostrum, which differs essentially in composition from milk, 
and is unfit for human food. It gradually, however, approximates milk, 
and the change may be regarded as complete by the eighth or tenth 
day. The fat of colostrum is in large lumps, and it contains much more 
albumen than milk does. Its average composition is shown by the follow- 
ing figures: 


Water. Albumen and Casein, Fat. Milk Sugar. Ash, 


73.07 19.21 RELY 3.00 1.18 


The Care of Milk. Milk should not be ai:towed to stand in copper, 
brass, or zinc vessels, nor in earthen vessels which are lined with lead 
glazing; for if the milk should become at all sour, traces of the metal 
may be dissolved in it. There is no objection to wooden vessels if they 
are kept scrupulously clean. But when emptied they should be scalded 
with boiling water, and then dried before they are refilled. There are 
also no objections to the best glazed earthen or to well tinned vessels. 

Milk should not be allowed to stand uncovered in an occupied room, 
nae in a sitting- or a bed-room. The fluid rapidly absorbs gases 
which may set up putrefactive changes in it. Besides, the dust which 
falls into it may contain disease germs, and these, finding a suitable place 
for their development, may multiply rapidly. There can be no question 
that milk has often served as the vehicle for distributing the germs of scar- 
let fever and diphtheria, which have fallen into it, or have been introduced 
with the water which has been used in diluting the milk, or for washing 
the vessels in which it is carried. 

Souring of Milk. This fluid, on standing, sooner or later becomes 
distinctly sour, and its casein is coagulated. This is due to the action 
of a ferment, which is always present in the milk, on the milk-sugar, 
which is converted into lactic acid. The coagulated casein is known as 
‘¢clabber,” and the fluid portion forms whey. ‘The best method of re- 
tarding the souring process in milk consists in keeping it in a cool place. 


tan < 


HEALTHY FOODS. 43 


Boiling has a similar effect, but it alters the nature of the fluid more or 
less. Milkmen sometimes add bicarbonate of soda to milk to prevent its 
souring. The alkali simply neutralizes the acid as fast as it is formed. 

Adulterations. While a great deal that is sensational has been said 
about the adulterations of milk, these frauds are perpetrated too fre- 
quently. A food which forms the principal, and in many instances the 
sole, sustenance of children, should be kept free from any adulteration 
which in any way lessens its nutritive value. To furnish a child with 
watered milk is often to slowly starve it to death, and the person guilty 
of such an act should be treated as a criminal. 

The adulterations practised in the sale of milk are as follows: 

(1) The addition of water, (2) the removal of more or less of the 
cream, (3) the addition of some foreign solid substance to increase the 
opacity or density of the fluid. 

The addition of water is the fraud most commonly practised. The 
amount added varies from ten to fifty per cent. of the milk; though the 
former figure is probably the one most frequently approximated. Several 
states have laws defining the amount of milk solids, which must be pres- 
ent. Wherever these laws are enforced they form a valuable protection 
to the consumer, and to honest dairymen as well. Unfortunately, there 
is no ready test capable of being used by any one, by which the exact 
amount of water can be determined. The amount of cream which 
forms on a given volume of milk standing in a tall glass tube or other 
vessel is a rough but valuable method which every housewife may em- 
ploy. From this she cannot say with certainty to her milkman that he 
has watered his milk, but she can tell him that the milk is not as rich as 
it should be. 

However, it must be remembered that the cream rises on milk much 
quicker under some conditions than under others. Watery milk may be 
produced by feeding cows upon sloppy food, such as the refuse from 
breweries, as well.as by the direct addition of water. Besides, watery 
milk often has a bluish color, and is not as opaque as healthy milk ; 
though this appearance is sometimes hidden by the addition of a yellow 
coloring substance, annatto. 

Skimmed milk is frequently sold for whole milk. In certain states 
there are very excellent laws against such a practice. The same rough 
test may be made as given above for watered milk. Sometimes skimmed 
milk is added to an unskimmed portion, and then sold as whole milk. 

The addition of foreign solids is not frequently resorted to. The most 
common substance used is bicarbonate of soda for the purpose of prevent- 
ing the souring of the milk, as has already been stated. In the amount 
used, it does not affect the food value of the milk. It is frequently said 
that chalk, gypsum, and gum arabic are added to milk. They may be 
used occasionally ; but stupid indeed must be the consumer who would 
not detect these substances, which, on account of their insolubility, would 
be deposited in the vessel. It has also been stated that the brains of 
calves and other animals are pulverized or ground fine, and placed in 


44 HEALTHY FOODS. 


milk. This is an adulteration found in sensational books, but not in 
milk. 

Diseased Milk. There can be no question about the possibility of the 
transmission of certain diseases from the lower animal to man through 


the use of milk as afood. In inflammation of the udder, the secretion of — 


the gland is diminished, and the act of milking causes the animal much 
pain. The milk is of unpleasant odor, and contains lumps of coagulated 
casein and albumen, and sometimes blood and pus. Such milk may 
cause irritation and even inflammation of the stomach in children. In 
all acute febrile diseases of cows the amount of the secretion is dimin- 
ished, and in severe fevers the flow of milk ceases altogether. In chronic 
diseases, as those of the digestive organs, the milk becomes thin and 
watery. 

The cause of the disease known as milk-sickness, which has prevailed 
in certain parts of Illinois, Indiana, Kentucky, Tennessee, Georgia, and 
some other states, has never been ascertained. Some ascribe it to plants 
which the cows eat; others are equally certain that the drinking water is 
the source. As the country becomes more improved, the disease appears 
less frequently. This would lead us to suppose that the poison is 
obtained from some native plant which is destroyed by cultivation of the 
soil. } 

Unfortunately, in many diseases of cows, during the first stages at 
least, the changes in the character of the milk are not sufficiently marked 
to be observed ;—however, the following kinds of milk should be avoided : 

(1) Milk which becomes sour and curdles within a few hours after it 
has been drawn, and before any cream forms on its surface. This is 
known in some. sections as ‘* curdly”’ milk, and it comes from cows with 
certain inflammatory affections of the udder, or with digestive diseases, 
or from those which have been over-driven or worried. 

(2) ‘* Bitter-sweet milk” is that whose cream has a bitter taste, is cov- 
ered with ‘‘ blisters,” and frequently witha fine mold. Butter and cheese 
made from such milk cannot be eaten on account of the disagreeable 
taste. 

(3) ‘*Slimy milk” can be drawn out into fine ropy fibres. It has an 
unpleasant taste, which is most marked in the cream. The causes which 
lead to the secretion of this milk are not known. 

(4) ** Blue milk” is characterized by the appearance on its surface, 
eighteen or twenty hours after it is drawn, of small indigo-blue spots, 
which rapidly enlarge until the whole surface is covered witha blue film. 
If the milk be allowed to stand for a few days, the blue is converted into 
a greenish or reddish color. This coloration of the milk is due to the 
growth of a microscopic organism. ‘The butter made from ‘‘ blue milk” 
is dirty-white in color, gelatinous in consistency, and bitter in taste. 

(5) ‘* Barn-yard milk” is a term used to designate milk taken from 
unclean animals, or those which have been kept in filthy, unventilated 
stables. ‘The milk absorbs and carries the odors, which are often plainly 
perceptible. Such milk may not be poisonous, but it is repulsive. 


HEALTHY FOODS. 45 


The Value of Milk as a Food. The importance of this article of diet 
can hardly be be over-estimated. For children, it is the mainstay. For 
adults, it is a substance palatable and easily digested. About two quarts 
of good rich milk per day will support life, even if no other food be taken. 
One sick with a wasting disease, such as typhoid fever, has his chances 
of recovery greatly increased if he takes milk with comfort and digests it 
with ease. For the infant, there is no other food which can fully sup- 
plant the milk of the mother. Physicians of large experience say that 
the chances of rearing a babe are 50 per cent. better when it is well sup- 
plied with healthy milk by its mother than when nourished by artificial 
preparations. Woman’s milk contains less fat and casein, and more 
sugar, than the cow’s milk. When it becomes absolutely necessary to 
substitute the latter for the former, the cow’s milk should be diluted with 
one third its volume of warm water, and one half ounce of milk-sugar 
should be added to each pint. As the child grows older, the amount of 
water added should be diminished, until, at the age of six months, undi- 
luted cows’ milk may be used. 

Condensed Milk. ‘This is prepared by evaporating milk in a vacuum 
to one fifth its volume, or to the consistency of honey, placing it in cans, 
which are set in water, the temperature of which is raised to the boiling 
point, when the cans are sealed. Sometimes cane sugar is added after 
evaporation. When used, condensed milk is diluted with five times its 
volume of warm water. It forms a valuable substitute for fresh milk 
when the latter cannot be obtained. Its exact value will depend upon 
the quality of the milk used in its preparation. The three most prom- 
inent brands of this preparation used in this country are the Anchor, the 
Swiss, and the Anglo-Swiss. The writer has examined these, and found 
them all of good quality. 


BUTTER. 


Of all the fats, butter is the most palatable and most easily digested. 
Only when it is rancid does it lead to dyspepsia. It, like all other fats, 
should be taken in a finely divided state. Its food value is great, and the 
amount consumed per head daily is about one ounce. 

Physical Properties. Good butter is of a pale yellow color, which is 
uniformly diffused through it. The exact color of butter varies with the 
food of the cow; but as a yellow butter is universally demanded in mar- 
ket, makers almost invariably use a preparation of annatto. This arti- 
ficial coloration has been so long practised, and as the use of the coloring 
material is not detrimental to health, it may be regarded as a legitimate 
use. Good butter is free from rancid taste and odor. White lumps in 
butter are due to the coagulation of casein, from the milk becoming too 
acid, and its incorporation with the cream. When a watery fluid exudes 
from the freshly cut surface of butter, it is evidence that the buttermilk 
was not expressed as thoroughly as it should have been, or that water 
has been added for the purpose of increasing the weight. 

Composition. ‘The amount of water in butter will depend upon the 


46 HEALTHY FOODS. 


manner of preparation and the quantity of salt added. In some families 
an unsalted butter is used. This does not contain more than from 3 to 
6 per cent. of water. But as a rule more or less salt is added in making 
the butter. This is done to insure the preservation of the fat, and most 
people consider such an addition an improvement to the taste. Good 
salted butter will not contain more than from 10 to 15 per cent. of water, 
while the poorer grades may contain as much as 28 per cent. This large 
amount is taken up only when boiling water is mixed with the fat, and 
then the whole allowed to cool. 

The salt used in butter should be finely pulverized and thoroughly 
mixed with the fat. From 3 to5 per cent. of salt is all that is needed for 
preservation, but in order to increase the weight, from 10 to 15 per cent. 
is sometimes added. Good butter contains from 85 to 90 per cent. of 
fat, and any which contains less than $2 per cent. may be considered as 
adulterated. The most common fraud in regard to the fat consists in the 
use of tallow and lard, which will be discussed under the heads of oleo- 
margarine and butterine. 

The greatest amount of casein permissible in butter is 2 per cent. If 
there be much more present, the butter is lumpy. There is now being 
sold to dairymen a recipe by which it is guaranteed that a given volume 
of milk will be made to yield 25 per cent. more of butter. The process 
consists in the coagulation of all the casein in the milk, and its incorpora- 
tion with the fat. The product is really not butter at all, but an inferior 
soft cheese. An excess of casein in butter increases its liability to become 
rancid. 

Flow to Take Care of Butter. Butter, like milk, takes up unpleas- 
ant odors: for this reason it should not be allowed to stand exposed to 
the air of occupied rooms, nor in other places that may become foul. 
When freely exposed to air butter becomes rancid: it should be tightly 
packed and covered. Warmth hastens rancidity: it should be kept in a 
cool place. 

OLEOMARGARINE AND BUTTERINE. 


Oleomargarine. ‘This substance is now largely manufactured and 
sold in this country, generally under the name of butter, but sometimes 
under its proper name. It is made as follows: The best beef fat is cut 
from the carcass while it is still warm. All bloody portions, and those 
tainted in any other way, are rejected. The selected fat is placed in 
fresh cold water, in which it is both cooled and washed. It is then 
ground like sausage. Then it is heated from 160° to 180° Fahr., by 
which the oil is separated from the membranes. The oil, after being 
salted, 1s cooled, and then pressed. ‘Then it is placed in milk, a prepa- 
ration of annatto added, and the whole churned, when it is worked as 
butter. The temperature at which the oil is separated from the mem- 
brane should be as low as possible ; but in practice it varies within large 
limits. Some manufacturers use a heat of only 120°, while others allow 
the temperature to run up to 200° F. The oilthus prepared is known to 
the trade as ‘‘ butter oil.” 


HEALTHY FOODS. 47 


Butterine. This is prepared by the mixture of ‘‘ butter oil” obtained 
from beef fat, as in making oleomargarine, and a similar oil obtained 
from hog fat, and churning with milk. The oil from the lard is sepa- 
rated at a temperature not exceeding 120° F. 

A great deal has been said against the use of these preparations as 
foods. Several states have laws which require that when such articles 
are sold, the buyer shall receive them from a vessel which is labelled 
with the word Oleomargarine, or Butterine, as the case may be, in 
letters one inch high, and the portion taken by the buyer shall be coy- 
ered with a paper which also bears the true name of the fat. This law 
is certainly a just one, as every article of food should be sold under its 
proper name; and the price of good butter should not be demanded for 
these imitations. At least two states,—New York and Michigan,—have 
enactments which wholly forbid the manufacture and sale of these prep- 
arations. ‘These laws are both unwise and unjust. Oleomargarine and 
butterine are valuable food-stuffs. They are not equal to the best grades 
of butter, but are far superior to the poor, partly rancid butter which 
is so generally sold in the large cities. As has been seen from the 
methods of preparation given above, only the very best pieces of fat 
can be used. Any fat which has an unpleasant odor, or is im the least 
degree foul, must be rejected, for there is no method known for remov- 
ing the odor. 

One of the greatest dietary needs of the working-man is a sufficient 
supply of an inexpensive, wholesome fat. This will be largely met by 
these artificial butters. 


CHEESE. 


Cheese is of considerable nutritive value, one pound containing as 
much nitrogen as two pounds of meat, and as much fat as three pounds 
of meat; but, as a rule, cheese is difficult of digestion, and can be taken 
only in small amount at a time. Moreover, the exact composition of 
cheese is quite variable. It is made both from whole and skimmed 
milk, and at present some is made from skimmed milk to which oleo- 
margarine or butterine has been added. The dairyman skims his milk, 
making butter from the cream; then to the skimmed milk he adds the 
fatty preparation, and makes cheese. In this way the same milk is made 
to produce both butter and cheese. It is a popular idea, that while cheese 
itself is digested with difficulty, a small amount of it in the stomach aids 
the digestion of other substances. The experiments of Dr. Edward 
Smith have confirmed this belief. As digestion is partly due to fermen- 
tation, and since cheese contains certain ferments, the belief is not irra- 
tional; but when taken as an aid to digestion, the amount should be very 
small, not more than from one half to one ounce. 

True cream cheese is made from whole milk, to which cream has been 
added ; but what is ordinarily known as ‘‘cream cheese” is that made 
from unskimmed milk. In such a cheese, the proportional amounts of 
casein and fat are substantially the same as in good milk. Skimmed 


48 HEALTHY FOODS. 


milk cheese is not so nutritious and not so easy of digestion as that made 
from whole milk. 

Cheese is almost universally colored with annatto, which, as it has 
been so long used and is not detrimental to health, may be regarded as a 
justifiable adulteration. Without it, cheese would be of a dingy-white 
color. 

EGGS. 


There is no bird whose eggs may not be eaten in case of necessity. 
However, the eggs of flesh-eating birds are of strong, unpleasant odor. 
Practically, our use of eggs as food is confined to those of the chicken, 
duck, Guinea hen, and goose. The exact taste of eggs is influenced 
largely by the food of the bird. The nutritive value of eggs is great, both 
on account of their chemical composition and their flavor. The average 
weight of hens’ eggs is from 134 to 2 ounces, the parts existing in the 
following proportions: 


shell sian. : : : : : : 11.5 per cent. 
Albumen (white), : : : : : : 50-5 hehe 
YiOlics ns : ; : : ‘ 4 30-0 hee 


The white of the egg consists of water and albumen, with traces of 
inorganic salts and fat. The yolk contains from 30 to 32 per cent. of 
fat; so that, practically speaking, the fat is confined to the yolk. There 
is not much difference in the time required for the digestion of a raw egg 
and one which has its albumen coagulated by heat, but the latter is the 
more agreeable in flavor. A hard-boiled egg is digested with more 
difficulty than one rarely done. 

Since eggs are most abundant and consequently cheapest during spring 
and summer, their preservation is of considerable importance. When 
left exposed to the air, germs pass through the shell and cause decompo- 
sition. Consequently, the object to be held in’ view in endeavoring to 
,preserve them is to exclude the air. This may be done by placing them 
in lime-water ; but in this way the shells are made very brittle, and many 
are broken in removing them. They may be dipped in mucilage, and 
then packed in salt. However, the most common method consists sim- 
ply in packing them in salt alone, or in salt and lime. Some dip the 
eggs for a moment in boiling water, whereby the part of the white 
immediately in contact with the shell is coagulated. 

Decomposed eggs will float in brine (made by dissolving one part salt 
in ten parts of water), while fresh eggs placed in the same solution will 
sink. 


VEGETABLE FOODS. 
CEREALS AND GRAINS. 


The cereals used as food in this country are wheat, rye, oats, corn, 
and rice. The most important food constituents of the grains are starch, 


4s) 


HEALTHY FOODS. 49 


proteids or nitrogenous substances, and the phosphates of the ash. They 
also contain small amounts of fat, sugar, gum, and mineral substances 
other than the phosphates. 

Of all the grains, wheat is considered the most nutritious. Its exact 
composition varies slightly, according to climate, nature of the soil, and 
the fertilization employed. Its average per cent. composition is given in 
the following figures : 


Water. Proteids. Fat. Sugar, Starch, Cellulose. Ash 


13.56 12.42 1.70 1.44 64.07 2.66 1.79 


The nitrogenous substances consist of vegetable albumen, casein, and 
gluten. The last mentioned forms by far the greater part of the nitrog- 
enous material. The ash may contain as much as 45 per cent. of phos- 
phoric acid, which is combined with lime, magnesia, and potash. Asa 
rule, the greater the amount of phosphoric acid in the ash of the wheat, 
the greater the amount of nitrogenous matter in the grain. 

Rye does not differ greatly in its composition from wheat, as is shown 
by the following figures, which give the average of forty-four analyses 
collected by Konig: 


Water. Proteids. Fat. Sugar. Gum, Starch. Cellulose. Ash. 


15.26 11.43 Fe7h 0.05 4.88 61.99 2.01 1 


However, the gluten of wheat is superior in quality to that of rye. In 
those countries whose inhabitants are compelled to depend largely upon 
rye bread, there is much suffering at times from poisoning with ergot. 
Fortunately, this poison is not found to any extent in wheat. 

Oat meal, which has been used as a food in Scotland for a long time, 
is now being largely consumed in the United States, and it is to be hoped 
that its use will become more universal. It isa highly nutritious, healthy, 
and cheap article of diet. The average composition of the grain is as fol- 
lows: 


Water. Proteids. Fat. Sugar. Gum, Starch. Cellulose. Ash. 


Pag TOT ha iat y OLE Te 7Oi 5 4.000 VE LCE (atm 


It will be noticed that the amount of fat is much larger than in wheat 
or rye. In the best specimens of the grain the fat may be as much as 8 
per cent. 

Corn is largely used in some of the Southern states, and, in the various 
ways in which the people know so well how to prepare it, it forms a 
most valuable food. The exact composition varies considerably with the 
variety of the plant and the soil on which it grows; but the following are 
the average figures: 


Water. Proteids. Fat. Sugar. Gum. Starch. Cellulose. Ash, 


os 7 9.85 4.62 ZAG WE RZO i OZR 7) 240 T5% 


The greater part of the nitrogenous material consists of vegetable fibrine. 
Rice grains have the following average composition : 


50 HEALTHY FOODS. 


Water. Proteids. Fat. Starch. Gum, Cellulose. Ash. 


9-55 5-97 1.84 73.00 2.85 5-80 I.09 


Since the per cents. of both proteids and fats are low, it:must be re- 
garded as the least nutritious of the grains here mentioned. However, 
its ease of digestion renders it valuable to the sick; and the fact that its 
heat-producing power is not so great as the other grains, adapts it to the 
inhabitants of warm countries. 

Barley, which is so largely used by the Scandinavians, and millet, 
which is a staple food in India and some other warm countries, are so 
seldom used in this country as foods that an extended notice of them is 
unnecessary. 

Buckwheat does not belong to the cereals, but to a wholly different 
class. However, as it is a food which is highly prized by many, it de- 


serves mention. ‘The plant soon reaches maturity, and may be grown — 


upon poor, sandy soil, as well as upon richer ground. The average 
composition is shown by the following figures: 


Water. Proteids. Fat. Gum. Starch. Cellulose. Ash. 


12.63 10.19 1.28 2.85 69.30 Teo 2.24 


The albuminous substances found in buckwheat differ materially from 
those present in the cereals. Its food value is not so great as that of 
wheat, rye, or oats. 


FLOUR AND MEAL. 


By grinding, the grains which have been described are converted into 


flour or meal. By this process the food material is better fitted for cook- — 


ing, and is to some extent separated from the indigestible portions. A 
few simple rules will be given by which good flour or meal may be dis- 
tinguished from the inferior grades: 

(1) Good wheat flour is white, with only a faint ellen tint. It does 
not contain any bluish, grayish, or dark specks. It feels soft and dry 
to the finger, and when some is pressed in the closed hand, it forms a 
dry lump, which breaks down readily with the gentlest pressure. If it 
‘fails to form a lump when pressed in the hand, it contains too much 
bran, or some mineral adulteration has been added. When the finger is 
introduced vertically into good flour, the depression thus made remains ; 
otherwise, there is too much bran present. The odor is fresh and pleas- 
ant, not musty. Neither with the unaided eye nor with a magnifying 
glass will any living bodies be found in good flour. 

(2) Rye flour has a grayish tint, and a characteristic odor and taste. 
The other general properties are identical with those of wheat flour. 

(3) The color of corn meal varies with the variety of corn from which 
itis prepared. It should feel perfectly dry and powdery. It does not 
‘¢lump” when pressed in the hand, and it has a characteristic, pleasant 
odor. Corn meal, when decomposition has begun, has a rancid odor, 
and if some of it be placed upon a piece of moistened blue litmus paper 

(which can be obtained atany drug store), the color of the paper will be 


HEALTHY FOODS. 51 


changed to red. Good meal has no effect on the color of the litmus 
paper. 

(4) Oat meal should be dry, and free from any disagreeable odor. 

The Care of Meal and Flour. When exposed to the air, flour and 
meal absorb water, and this greatly increases their tendency to decom- 
pose. In moist flour the lower forms of life are likely to develop. For 
these reasons these preparations should be kept in well closed recep- 
tacles. 

Adulteration. Fortunately, these foods are very rarely adulterated in 
this country. Since wires have been used so extensively for binding in 
the great wheat fields of the North-west, a small amount of iron is found 
in flour, as an accidental adulteration. It is frequently stated that gyp- 
sum and other mineral substances are added to flour, but the writer has 
examined many hundred samples, and has never detected such an adul- 
teration. It hasalso been stated that the so-called ‘‘ patent flour” contains 
alum. This is certainly false. One of the writer’s students examined 
twenty-three samples of ‘‘ patent flour” obtained at different places, and 
failed to find any alum present. It may be possible that in some instances 
the cheaper flours or meals are added to wheat flour ; but even this fraud, 
if practised at all in this country, is carried on to a very limited extent. 
The great abundance and low price of wheat would tend to make any 
adulteration profitless. 


BREAD. 


The cooking of his food is one of the earliest evidences of man’s civil- 
ization, and with no other food has the process of cooking been so thor- 
oughly developed as with the products obtained from the edible grains. 
The essential constituents of bread are flour, water, and salt. To these 
have been added, for the purpose of varying and improving the taste, one 
or more of the following substances: Milk, sugar, eggs, fats, etherial 
oils, and fruits. Civilized man, in every part of the world, employs 
some means of raising or leavening his bread. By this the taste is im- 
proved, and the crumb, being divided by the evolved gas, is more readily 
acted upon by the digestive juices. The methods of raising bread are as 
follows : 

(1) By the Growth of Yeast. Yeast consists of microscopic vegeta- 
ble organisms, which, when placed in a suitable medium, grow rapidly, 
producing alcohol and carbonic acid gas. The evolved gas, in attempt- 
ing to rise, becomes entangled in the meshes of the dough, distending it 
and making it light. After the dough has risen sufficiently, it is placed 
in a hot oven to bake. The heat destroys the yeast plant, and thus pre- 
vents further fermentation. If the growth of the yeast be allowed to con- 
tinue for too long a time, acetic, lactic, and butyric acids are formed, and 
such dough makes ‘* sour bread.” 

(2) By Baking Powders. In the use of baking powders, the car- 
bonic acid gas, necessary to render the dough light, is generated by 
chemical means. Baking powders consist of some alkaline carbonate, 


52 HEALTHY FOODS. 


as sodium bicarbonate, and some acid substance, such as the acid tar- 
trate of potash (cream of tartar), together with a small amount of starch 
to keep the mixture dry. As long as the powder is perfectly dry no 
reaction occurs, but when it is dissolved in water in the dough, the acid 
acts upon the carbonate, liberating carbonic acid, which has the same 
effect in raising the dough as when it is produced by the growth of the 
yeast plant. 

In baking powders, ammonium carbonate is sometimes used instead 
of sodium bicarbonate ; and the acid tartrate may be replaced by the acid 
phosphate of lime. But the use of alum in baking powders is an adul 
teration which is injurious to health. It unites with the phosphates in 
the bread, rendering them insoluble, and preventing their digestion and 
absorption. In this way alum, when present, diminishes the nutritive 
value of bread. 

A small amount of starch in baking powders is necessary to keep them 
dry, but too often the manufacturer adds as much starch as possible, 
and_this should be considered as an adulteration. 

(3) By Aeration. In some large bakeries carbonic acid gas, gener- 
ated by the action of some acid on carbonate of lime, is forced under pres- 
sure into the dough, thus distending the mass; or the dough is kneaded 
with water which has been saturated with carbonic acid under pressure. 
When the gas is washed before being forced into the dough or water, this 
method is a very desirable one. But the cost and care of the special 
apparatus necessary will prevent the adoption of this method of raising 
bread, except in large bakeries and hotels. 

General Properties of Good Bread. The general statements con- 
cerning bread refer to that made‘from wheat flour. Good bread hasa 
thick, fragile crust, which is not burnt, and which forms from 25 to 30 
per cent. of the weight of the loaf. ‘The crumb is white, and filled with 
cavities, the partitions between which are easily broken down. ‘These 
cavities should be distributed through every part of the crumb; other- 
wise, the bread is sodden’ and heavy, and decomposes quickly. The 
bread should be of a pleasant odor and taste. If the bread is acid, it was 
probably made from inferior flour. 

Changes on Standing. On standing, bread gradually loses weight, 
by the evaporation of a part of its contained water, and becomes hard. 
The amount of water given off in a certain time will depend upon the 
size of the loaf and the nature and extent of the crust. Bread should not 
lose more than 3 per cent. of its original weight after four days. Stale 
bread when dipped in water and rebaked, or when steamed, becomes 
palatable, but never completely regains the properties of fresh bread. In 
stale bread, small living organisms are likely to develop. Some of them 
are poisonous. The white and orange-yellow moulds which form on stale 
bread are due to a poisonous growth. Sometimes blood-red spots appear 
in bread. ‘These also are due to a microscopic growth. 

Adulterations of Bread. Bread is not adulterated to any great extent 
in this country. The baker’s loaf is usually of light weight. An excess 


HEALTHY FOODS. 53 


of water is often incorporated with the dough. This makes the bread 
sodden and heavy, and increases its liability to decompose. In some of 
the larger cities, mashed potato has been found worked into bread. This 
lowers the nutritive value of the article greatly. Alum is sometimes 
added directly to flour or dough, and is sometimes contained in the bak- 
ing powder, as has been stated. 

The Food Value of Bread. As has been remarked, the most impor- 
tant food constituents of the grains, and consequently of bread, are the 
proteids, starches, and ash. The amount of nitrogenous matter is too 
small for a perfect food, and for this reason bread is often taken with 
some other food richer in nitrogen, such as meat. Bread is also defi- 
cient in fat, and man instinctively takes some kind of fat, such as butter 
or bacon, along with his bread. Notwithstanding these imperfections, 
bread is a food of which we never tire, and the various ways in which it 
is prepared aid in sharpening the appetite. Besides, while some impor- 
tant food substances are not abundant in bread, all are present to a greater 
or less extent ; and with the addition of a little more nitrogen in the shape 
of meat and fat, as butter or bacon, a perfect diet is secured. 


PEASE AND BEANS. 


Pease and beans belong to the leguminous seeds. They contain more 
nitrogenous matter or proteids than any other vegetable food. Not only 
is the amount of proteid greater than in wheat and other grains, but it is 
different in its properties. That of the grains is principally gluten, while 
that of pease and beans belong to the casein group. The former is more 
easily digested than the latter, pease and beans often causing disturbances 
in the stomach and bowels. The average composition of these foods is 
shown by the following figures : 


PEASE. 

Water. Proteids. Fat. Starch. Cellulose. Ash. 
14.99 24.04 1.61 49.01 7.09 3.26. 
BEANS. 

Water. Proteids. Fat. Starch, Cellulose. Ash. 
14.76 24.27 1.61 49.01 7.09 3.26 


There is great difference between the digestibility in these substances 
in the green and inthe dried state. Soft green pease tax the stomach 
but slightly. Dried pease and beans must be boiled slowly and for a 
long time; and if they are very old, they should be soaked for several 
hours, and then crushed before they are cooked. Hard water is to be 
avoided in cooking them, as the lime of the water forms an insoluble 
compound with the albuminous constituents of the seeds. 

Ground pease and beans are used to some extent in this country. They 
form a part of some food preparations, such as pea-sausage (erbswiirste 
of the Germans). 


54 HEALTHY FOODS. 


Food Value of Pease and Beans. The nutritive value of the seeds 
is considerable, but on account of the tax which they impose upon the 
digestive organs, they cannot be taken in large quantities. The deficiency 
of fat is usually supplied by serving these foods with bacon or other fatty 
food. 


POTATOES. 


Potatoes contain only about 25 per cent. of solids, four and five-tenths 
of which is starch. The per cent. of nitrogenous matter and fat is small 
_ as shown by the following figures, which give the average per cent. com- 
position of potatoes: 


Water. Proceids. Fat. Starch. Cellulose. Ash, 


75.97 1.79 0.16 20.56 0.75 0.97 


Notwithstanding its comparatively small per cent. of solids, the potato 
will continue to be one of the most valuable foods. Its growth is not 
influenced by soil and climate to such an extent as that of the cereals. 
The yield of the potato per acre is greater than that of any other vegeta- 
ble. Itis preserved with ease for winter’s use, and the raw material is 
fitted for the table with but little trouble and expense. It can be served 
in a great variety of ways, and with other foods. Its deficiency in nitrog- 
enous matter and fat is made up by cooking it with meat. It is agreea- 
ble to the taste, and easy of digestion. New potatoes are said to be 
waxy, and not so easily digested as old, mealy ones. In order to retain 
the salts, potatoes should be cooked with their skins on. If boiled, they 
should at once be placed in hot water. If baked, the oven must be mod- 
erately hot. 

Potatoes should be of fair size, firm, and free from mould. The sweet 
potato is similar in composition to the ordinary potato, and furnishes an 
agreeable substitute: but it is more expensive, and cannot be preserved 
so easily 


OTHER VEGETABLES. 


The other succulent vegetables which are used as foods are principally 
useful on account of furnishing variety, and for the acid salts which they 
contain, and whose use renders other foods more digestible, and prevents 
scurvy and kindred affections. 

The beet root is not only a pleasant food, but furnishes as much as 10 
per cent. of sugar, for which it is now largely grown; though the differ- 
ent varieties of the root vary considerably in the amount of sugar which 
they contain. . 

Turnips, carrots, and parsnips contain from 82 to 90 per cent. of water, 
from 5 to 10 per cent. of starch, from 2 to 6 per cent. of sugar, about 1 
per cent. each of nitrogenous matter and salts, and } per cent. or less of 
fat. 

Cabbage, turnip tops, spinach, water-cresses, dandelion, and other 

greens” should always be thoroughly cooked. The amount of absorb- 
able food which they contain is generally less than 5 per cent. 


be 


HEALTHY FOODS. ) 


The tomato, either raw or cooked, furnishes an agreeable sauce. It is 
also used for making soup and for flavoring meat soups. It contains over 
92 per cent. of water, less than 2 per cent. of starch, and about 24 per 
cent. of sugar. 

Rhubarb is a pleasant, acid vegetable, which is especially serviceable 
on account of its being one of the earliest of spring plants. 

Pumpkins and squash contain from 1 to 5 per cent. of starch, about 1 
per cent. of sugar, and less than 1 per cent. each of nitrogenous matter, 
fat, and ash. 

Thoroughly ripe melons are beneficial in season on account of their 
action upon the kidneys. They should never be eaten, however, unless 
they are thoroughly ripe and of good quality. 


STARCHES. 


The food value of the starches is small, but they are easy of digestion, 
and are serviceable in preparing dishes for the sick. Besides, when mixed 
with nitrogenous and fatty substances, they are largely used in making 
puddings. In this way, stale bread and other remnants from the table 
may be converted into palatable dishes. 

Sago and arrow-root are obtained from various palms. The former 
appears in small granular masses, which, when dry, are so hard that they 
can scarcely be crushed by the teeth; but they readily absorb water, and 
soften. 

Arrow-root, when pure, is found in perfectly white lumps, which may 
readily be crushed between the fingers. When boiled with water and 
constantly stirred, no foam should form on the surface. The presence of 
a foam indicates that the arrow-root has been adulterated with flour. 

Tapioca, obtained from various tropical plants, and corn and potato 
starches, are also used in puddings. 


SUGARS. 


Sugar is a name now given to a class of substances which vary among 
themselves to some extent both in physical and chemical properties, 
though ordinarily the term ‘‘ sugar” is supposed to refer to that obtained 
from the sugar-cane and sugar beet. Practically there are now in the 
trade three kinds of sugar,—cane sugar (obtained from the cane and 
beet), glucose or grape sugar (obtained by the action of dilute acids on 
starch), and ‘‘ mixed sugars,” or ‘‘new-process sugars” (consisting of 
cane and grape sugar mixed in various proportions). Cane sugar is 
here referred to, unless some other is specifically mentioned. 

Sugar is used for modifying the taste of other foods, and for the manu- 
facture of confectionery and syrups. By improving the taste, sugar, 
when added in proper amounts, aids the digestion of other substances, 
and furnishes a certain amount of nutriment in itself. 

Good,, crystalline, white sugar contains less than one half of 1 per 


56 HEALTHY FOODS. ‘ 


cent. or water, and not more than this amount of ash. Yellow sugar 
may contain as much as 2 per cent. of water. 

Grape sugar may contain from 10 to 25 per cent. of water, and from 
one half to 2 per cent. of ash. 

Much has been said about the adulteration of sugar with glucose. ‘That 
this has been practised to a considerable extent is shown by numerous 
analyses. Indeed, ‘‘ mixed sugars” are sold by wholesale dealers, and 
too frequently the retail grocery-man sells these to his customers as 
straight cane sugars. 

Experts can recognize these sugars by the way they ‘‘ handle.” ‘* They 
are apt to cake and harden, and stick to the scoop and sides of the barrel. 
In the white, granulated sugars, the mixture of the white lumps of glu- 
cose with the crystalline cane sugar can be readily seen; but in the brown 
sugars it is difficult to detect the fraud by the appearance of the sugar. 
When a mixed sugar is shaken with cold water, the white lumps of the 
glucose will remain undissolved for some time after all the cane-sugar has 
passed into solution.” 

Glucose, when made with care,—and it must be so made when it is used 
to adulterate sugar,—is not harmful to health. The fraud is a pecuniary 
one, as glucose costs usually less than two cents per pound; but when 
mixed with sugar, it is sold for six cents and more per pound. The 
sweetening properties of glucose are not so great as those of cane sugar, 
and consequently, in the preparation of foods, much more of the mixed 
sugar is required than would be necessary with cane sugar. 

Confectionery. ‘The various candies are made from sugar, or sugar 
and starch, with or without coloring matters. Twenty-seven samples 
were examined under the writer’s direction, in order to ascertain whether 
or not they contained any poisonous substance. One sample consisted 
wholly of starch, terra alba, and an analine color, without any sugar. 
The use of terra alba (white earth, or clay) in any considerable amount 
would be harmful on account of its indigestibility. Only two samples 
contained ultra marine as a coloring agent. This would also be harmful 
if used in large quantity. ‘The other samples were all free from any sus- 
picious ingredient. ‘The coloring agent most frequently used is analine. 
Grape sugar is extensively employed in the manufacture of confectionery. 

floney. This is frequently adulterated with glucose, which may be 
added directly to strained honey, or may be fed to the bees, and by them 
deposited in the comb. Unadulterated honey varies in flavor according 
to the plant from which it is gathered. White clover and buckwheat 
honeys are much prized in this couutry. The fact that honey sometimes 
produces unpleasant symptoms is probably due to bees feeding upon 
poisonous flowers, though the susceptibility of the individual partaking 
of it probably plays an important part. Pollen grains are often mixed 
with honey, and the unpleasant effects upon the system may be, in part 
at least, due to these. 

Molasses and Syrups. ‘These are solutions of sugar, and they are now 
frequently made by a mixture of cane syrup and glucose. Indeed, many 


9 HEALTHY FOODS. : 57 


prefer a syrup containing glucose: it is not so sweet as a pure cane-sugar 
molasses. However, the former should be much cheaper than the latter. 
As in the case of sugar, the fraud here practised is a pecuniary one rather 
than one detrimental to health. 


FRUITS. 


Fruits abound in tropical and temperate climates, and furnish a great 
variety of flavors, which are useful in themselves and for the purpose of 
rendering other foods more enjoyable. The real food value of fruits, 
judged by their chemical composition, is small, but when thoroughly 
ripe and well preserved, they act beneficially upon the system, improv- 
ing the appetite, and maintaining a healthy condition of the various vital 
organs. Probably no fruit is necessary to life, and fruits may be regarded 
as luxuries ; but man’s instinct and cravings prompt him to obtain them 
often, even when their cost is considerable. Undoubtedly they are most 
highly prized by the inhabitants of warm countries, where foods which 
produce but little heat are most desirable. The most enjoyable part of 
fruits is their juice, which consists principally of watery solutions of 
sugar and acids. The amount of sugar in fruits varies from 1 to 18 per 
cent. The cellular parts are not easily digested; and those fruits are 
prized most highly which have the greatest quantity of juice with the 
smallest proportion of cell structure. 

The majority of fruits may be eaten either raw or cooked, and those | 
which cannot be preserved in their natural condition may be dried. 
Therefore, in one or the other form, they may be enjoyed at any season 
of the year, and may be served with other foods. 

The volatile ethers, upon which the flavor of many fruits depends, have 
been made artificially by the chemist, and, under the name of essences, 
are largely used in cooking. 

It is wholly unnecessary even to mention the various fruits in®use, as 
all are sufficiently acquainted with their general properties and composi- 
tion. Suffice it to say, that thoroughly ripe fruit, taken in moderation, 
_ can have no deleterious effect upon the system. However, care should 
be exercised in using fruits imported from countries in which an infec- 
tious disease, such as cholera, prevails. Such fruit should at least be 
thoroughly washed, or stripped of its covering, and, if suitable for such 
purpose, should be cooked. 

Canned Fruits. In buying canned fruits, it should be observed that 
the ends of the cans are concave. If convex, there has probably been 
some decomposition of the contents with the evolution of gas. Cases of 
severe poisoning have followed the eating of partially decomposed canned 
fruits. Moreover, if the cans appear old and battered, thus giving evi- 
dence of having been used twice or oftener for the purpose of preserving 
fruit, they should be rejected, since the contents of such cans are liable to 
contain small amounts of tin or other metal, which may prove poisonous. 
Much having been said about the use of salicylic acid, in canned fruits, 


58 HEALTHY FOODS. 


as a preservative agent, the writer requested one of his students to examine 
samples from all the more prominent firms engaged in the preparation of 
canned foods, for this adulteration. In no case was theacidfound. Fre- 
quently agents pass through the country, offering to sell preparations or 
recipes for the sure preservation of fruit. The active ingredient of all 
these formulas is salicylic acid or some form of sulphurous acid. The 
use of such preservatives is unnecessary. Moreover, they injure the taste 
of the fruit, and are liable to prove deleterious to the health of the con- 
sumer. 

Prof. Sharpless states that ‘‘ apple-sauce” is frequently pumpkin boiled 
with cider; that the raspberry-jam offered for sale is often sour; and that 
strawberry-jam is frequently made from the refuse strawberries of the 
market. 

NUTS. 


Judging solely by chemical composition, nuts should be classed among 
the most nutritious foods. The following figures give the percentage 
composition of sweet almonds, walnuts, and hazelnuts, from numerous 
analyses collected by Konig: 


Starch and 
Water. Proteids. Fat. Sugar. Cellulose. Ash. 
Amon s see cn oe 45880 24.18 53-68 Ve 6.56 2.96 
MWVeinuts | ay) Gh.) eS 16.37 62.86 7.89 OE? 2.03 
TIAZEINUES, his ye ea eT 15.62 66.47 9.03 3.28 1.83 


But nuts are not easily digested, and, with the exception of cocoa-nuts, 
do not form an important part of the food of any people. They may be 
regarded simply as luxuries, so far as their use in this country is con- 
cerned. Crushed acorns are used to some extent in the adulteration of 
ground coffee. 

VEGETABLE OILS. 


On account of our abundant supply of animal fats, the vegetable oils 
are not extensively used as foods in this country. The one best known is 
olive oil, which is used as a dressing for other foods. Olive oil, how- 
ever, has been largely adulterated, or supplanted, by cotton-seed oil, 
large quantities of which are sold as olive oil. 


CONDIMENTS. 


Condiments are substances whose employment in cooking is for the 


sole purpose of seasoning foods. However, at least one member of this 
class,—common salt,—is essential to healthy existence. Condiments im- 
prove the taste of foods, sharpen the appetite, and improve digestion. 
While much benefit arises from this use in small amounts, when taken in 
excess they may prove highly detrimental to health. | 

It is stated that certain tribes in the interior of Africa exchange gold 
for salt, ounce for ounce. This illustrates the great need of this sub- 
stance felt by the animal system. We know that wild animals some- 


— -* 


HEALTHY FOODS. - 59 


times travel hundreds of miles in search of salt-licks. Experiments have 
been made, in which two oxen were placed under exactly the same con- 
ditions, and furnished with the same food, save that salt was denied one, 
and given to the other. The one deprived of salt did not thrive-as did 
the other. 

The purity of salt is judged of by its whiteness, fineness, dryness, and 
perfect solubility in water. The coarser kinds of salt contain compounds 

of lime and magnesium, are often dark in color, and absorb moisture 
from the atmosphere. 

Vinegar is an acid fluid, which may be produced by the fermentation 
of any solution containing sugar. Cider and wine vinegars are most 
highly prized, though the following varieties are now sold in this country: 

(1) Cider vinegar, from apples and pears. 

(2) Wine vinegar, from grape juice and inferior wines. 

(3) Malt vinegar, from barley. 

(4) Beer vinegar, from sour ale or beer. 

(5) Glucose vinegar, from grape sugar. 

(6) Crab vinegar, from crab-apples. 

(7) Artificial vinegar, made with dilute solutions of the mineral acids, 
especially sulphuric acid. | 

The acidity of vinegar is nominally due to acetic acid. Sulphuric acid 
is sometimes added to increase the acidity. The British law allows this 
adulteration to the extent of one tenth of one per cent. ; but if the vinegar 
be properly prepared, such an addition is not necessary; and if any 
addition be allowed, the amount is likely to exceed that given above. 
Burnt sugar is sometimes added to vinegar to give it color. 

The per cent. of acetic acid should be at least 3. Of five samples 

recently examined, the smallest per cent. was 3.2, and the greatest, 6.7. 
Only minute traces of mineral acids were found in three of these sam- 
ples, while the other two were wholly free from such adulteration. 
_ Table mustards are frequently diluted with tumeric, flour, or yellow 
lakes. Pepper is sometimes mixed with flour, bread, or starch. Spices 
are frequently adulterated with flour, starch, bread, and ground pea-nut 
shells. Cloves may contain arrow-root. In order to obtain spices pure, 
they should be purchased unground. 


TEA. 


Tea is the most extensively used and the least harmful of all beverages. 
Upon most persons it produces agreeable sensations; ‘‘ it cheers, but 
does not inebriate.” It relieves, to a certain extent at least, the feeling 
of bodily weariness, quickens the pulse, and deepens the respiration. 
Upon the nervous system it acts as a stimulant, and the excitation is not, 
as in the case of alcoholic drinks, followed by depression. Considerable 
discussion has been carried on over the question whether or not its use 
increases waste of tissue. This may now be considered as settled in the 
affirmative. Dr. E. Smith and others have repeatedly shown that the 


60 HEALTHY FOODS. 


amount of waste matter in the air exhaled from the lungs is markedly 


increased. ‘Tea, then, acts as a food principally by hastening the oxida- 
tion or burning of other substances in the body. 

It creates a blast which burns up the half charred dédrzs of the system, 
and from the burning or oxidation we receive increased energy. From 
what has been said, it will be evident that the only time when tea should 
be used is late in the day, after the heaviest meals have been taken. For 
the weak and debilitated it is not suitable, or should be used very spar- 
ingly. Its tendency to produce sleeplessness may also restrict its use. 

So far as its chemical composition is concerned, tea contains but little 
of nutritive value. The high place of tea among foods is solely due to its 
effect upon the nervous system. 

In the market there are two kinds of tea,—green and black. Until 
recently it was supposed that these were products of different species, or 


at least of varieties, of the tea plant; but it is now known that the two 


kinds arise from different methods of curing the leaves. In preparing 
green tea, the leaves are dried immediately ; while in the other, the leaves 
are thrown into heaps, and a certain degree of fermentation or decompo- 
sition is allowed to take place before the drying is perfected. 

The chief constituents of tea are its active principle called theine, which 
is identical with the active principle of coffee, a volatile oil, tannic acid, 
and a small amount of ordinary food substances. 

Theine forms from 2 to 3 percent. of tea. In making tea, as is ordina- 
rily done, the greater part of the theine is dissolved out of the leaves,— 
tea yielding its active principle to water more readily than coffee. From 
equal weights, three times as much theine is obtained from tea as from 
coffee. According to the investigations of Mr. Fellows, 224 five-ounce 
cups of tea beverage are made from one pound of tea, and 45 eight-ounce 
cups from a pound of coffee. This makes the cost of an ordinary cup of 
tea, when the leaf sells at 75 cents per pound, about one third of a cent; 
and of a cup of coffee, when the berry sells at 27 cents per pound, about 
three fifths of a cent. In this estimation the sugar and milk added to 
these beverages are not considered. 

The volatile oil of tea is the special stimulant, and the market value of 
a tea depends moré upon this than any other constituent. The amount 


and quality of this substance present are judged by the odor as well as by 


the taste of the hot beverage. Large tea houses have experts who are 
called ‘‘ tea-tasters,”’ and whose duties consist of deciding as to the value 
of different samples by the odor and taste. By virtue of the volatile oil, 
tea increases the flow of perspiration, and thus, although taken hot, may 
act as a cooling agent. ‘The volatile oil is more abundant in green than 
in black tea. 

Tannin is also more abundant in green than in black tea. The object 
in making tea should be to dissolve as little of the tannin as possible, and 
at the same time extract as much as possible of the theine and volatile oil. 
To accomplish this, tea should be steeped five or ten minutes, by no 
means longer than ten minutes ; but the water should be kept warm after 


HEALTHY FOODS. 61 


that until the beverage is drawn for drinking. Mr. Fellows found the 
amount of tannin extracted from the best Japan tea, after steeping for 
five minutes, to be 0.10 per cent.; after ten minutes, 0.98 per cent. ; 
after thirty minutes, 3.09 per cent. It is to the tannin that the astringent 
properties of tea are due, and when tea has been boiled, it is so astrin- 
gent that it is well-nigh unfit for use, and indeed may cause derangements 
of the digestive organs. 

Tea contains small amounts of albuminous and starchy substances, but, 

as has been stated, these are present in such small amounts that they are 
not worthy of consideration. 

Tea is subject to the following adulterations, which, fortunately, are 
not largely used at present : 

(1) ‘* Spent” leaves, those which have been once used for making tea, 
are dried, and mixed with fresh leaves. This adulteration is not practised 
extensively in this country. 

(2) The poorer varieties are mixed with the better, and the whole sold 
as of first quality. 

(3) Green tea is sometime tinted with indigo and gypsum Prussian 
blue is said also to be used, but the writer has failed to detect it after ex- 
amining many samples. Black tea is also tinted with graphite. This is 
not used in large amounts, and, as used, is not detrimental to health, but 
is a pecuniary fraud. 

(4) Other leaves, notably those of the willow, elder, and beech, are 
added to the tea leaves. None of these are exactly like the tea leaf, and 
the adulteration may be detected by close inspection, even without a 
microscope. ‘The border of the tea leaf is serrated nearly, but not quite, 
to the stalk. The primary veins run from the midrib nearly to the bor- 
der, and turn in so that there is a distinct space left between their termi- 
nations and the border. 

Tea dust, which consists of broken leaves and sweepings of tea storage 
houses, is a legitimate article of commerce, yielding an average of 1.27 
per cent. of theine. 


COFFEE. 


It is unnecessary to go into detail concerning coffee, since it resembles 
tea in so many of its properties. The active principle of coffee, called 
caffeine, is identical in chemical composition and physiological effects with 
theine of tea. The per cent. of this substance in the raw coffee berry is 
about one, and this is not given up so readily to water as that in tea. 

There is no volatile oil, corresponding to that of tea, in raw coffee ; but 
one or more such oils are generated by roasting. The physiological action 
is not the same, however, as that of tea. It is not so stimulating, nor 
does it increase the perspiration to so great an extent. 

Tannin is present ina much smaller amount than in tea, and for this 
reason the steeping of coffee may be carried on longer than ten minutes. 

The unground coffee cannot be adulterated to any extent; but the 
ground coffee put in packages and boxes is almost universally adulterated. 


62 | HEALTHY FOODS. 


Often it contains no coffee at all. A student of the writer examined all 
the specimens that could be obtained in the market. The first, known 
as Java coffee, put up by the ‘‘ Centennial Coffee Company,” of New 
York, contained, besides some coffee, chickory, pease, wheat, acorns, 
and corn. The second, ‘‘ Gillies Gold Medal Java,” contained very little 
coffee, being composed principally of wheat, much of it unground chick- 
ory, corn, and pease. The remaining samples were ground coffee, sold 
in bulk, and in every case adulterated. 


CHOCOLATE. 


Chocolate is prepared from the ground seeds of the fruit of the cocoa 
palm. Cocoa nibs consist of these seeds, which are about the size of 
almonds, roughly broken, while chocolate contains a substance,—theo- 
bromine,—very similar, but not identical with theine or caffeine ; its other 
constituents give it a very different position in the class of foods. The 
cocoa seeds contain from 45 to 49 per cent. of fat, and from 14 to 18 per 
cent. of nitrogenous matter. It will be seen from this that these seeds 
may be classed among the most nutritious foods. Chocolate always con- 
tains sugar, which has been mixed with the ground seeds. 

Chocolate does not stimulate the nervous system to anything like the 
extent that tea and coffee do; but for travellers and others who cannot 
obtain milk, chocolate may be used instead of that, the most nutritious of 
liquid food. 

Chocolate is often adulterated by the addition of too much sugar, or 
with starch. 


Faigle es fl ae wad fel 
; Sat aoa Ae 


, ‘ A yi 
* \ f s 
. 
By D. F. LINCOLN, M. D., 
Boston, Mass. 
DA VENIAM PUERIS. ; 
| 
’ \ ; 
’ 
] ‘ 
A ‘ os 
aN De AG 
Re aaa f BN th, Ar NaS AD Aa 


; A Ric i te. a tae 1 445s ie ie 


th i i By Irvina A. WATsoN, SEC. AMERICAN PuBLic 
Rie (: | All Rights Reserved. 


SCHOOL HYGIENE. 


INTRODUCTORY. 


Two men should be mentioned at the head of an essay of this sort, as 
deserving to represent the beginning of the ‘‘ movement” in school 
hygiene. They are Cohn of Breslau, whose examinations of the eyes of 
school-children made a very powerful impression on the public mind 
some sixteen years ago, and Virchow, whose official report to the Prus- 
sian minister of education (published in 1869), is the most prominent 
document that can be referred to as leading the way in reform. 

It is not intended in this essay to quote largely from German authori- 
ties. The mere statement of principles and facts must suffice in so wide 
_and manifold a subject as the present. 

It should be noted that Virchow makes use of the expression ‘ school- 
diseases.” He is probably entitled to the credit of inventing the word. In 
the list which he gives there is one affection which we need not dwell 
upon, namely, nose-bleed. In regard to another,—tubercular consump- 
tion,—there is perhaps a deficiency of evidence as to its causation in 
schools in America, though there can be no reasonable doubt that it is 
so caused, and the writer has the highest American authority for saying so. 

Deformity of the spine (lateral curvature) is probably not so common 
‘by a good deal in America as Guillaume represents it in Switzerland. 
We lack decided evidence ; but it is spoken of under the proper heads in 
this essay. 

It remains to note the division of the subject which has been followed, 
vic. : 

I. Site of the School-House. 

2. Plan and Arrangement of the Building. 

3. Ventilation and Heating. 

4. Sewerage. 

5. Hygiene of the Eye. 

6. School-Desks and Gymnastics. 

7. Affections of the Nervous System. 

§. Contagious Disease. 

9. Sanitary Supervision. 


I. SITE. 


In choosing the site for a school-building, we should take into account 
a number of things which might be overlooked in the case of an ordinary 
building. Dampness and malaria are of course fatal to a site for any 
purpose. For schools we must plan to have abundant light (much more 
than will suffice for dwellings and shops), and to have the sun’s direct 


66 SCHOOL HYGIENE. 


rays enter each room at some time of the day. The business of the 
school requires the absence of noise,—a point which may be overlooked 
in business edifices; and the social character of the neighborhood, and 
its moral nuisances, are also to be considered. 

Dampness. Without going much into details, the use of some method 
of drainage and of some shield against incoming water is suggested, as 
likely to be needed in many places. The cellar, as hygienists know, 
ought to be carefully guarded f-om contamination of soil and air, and 
should at all times be dry. Grading will suffice to keep off most of the 
surface water. Underground water may be provided for by a ditch, dug 
outside of the foundation and reaching deeper than the cellar floor, and 
either laid with drain tile, or filled to the depth of a foot with loose 
stones, after which earth is thrown in. A similar trench may be cut in 
‘the floor. All such drains are to be led to a proper place for discharge. 
The floor may be made damp-proof, according to Col. Waring’s sugges- 
tion, by six inches of well rammed clay, or by asphalt between two layers 
of cement; the foundation walls may be protected by a coating of asphalt 
outside. A damp-proof course of asphalt in the walls above the ground 
is useful in preventing moisture from rising. 

Small country schools, if without a cellar, should at least have an air- 
space underneath the floor, with a few openings in the underpinning, to 
give ventilation to the space. 

River bottoms, places where mist is often seen, and the neighborhood 
of ponds, are undesirable places for building. No business is more inter- 
fered with by noise than that of school. The neighborhood of large fac- 
tories, saw-mills, foundries, railway stations, engine-houses, or police 
stations, is therefore to be avoided. There need be no excuse for placing 
a school-house near any such of the latter as are under public coutrol, or 
for utilizing a town lot by putting engine-houses, school-houses, and a 
police station, in close neighborhood. Regard ought to be had for the 
probable growth of a city, and avenues likely to become main lines of 
travel should be avoided. These things are mentioned because they are 
sometimes strangely disregarded. In large cities it is next to impossible 
to procyire sites which fully satisfy the demand of hygiene in respect to 
the supply of light. Corner lots are enormously expensive, besides being 
noisy. The Sanztary Engineer prize designs for public schools, pub- 
lished in 1880, are instructive as showing that in the opinion of the prize 
committee,— 

‘¢ The most essential thing in a public school is sufficient light. The 
conditions imposed in this competition make it impossible to secure this 
light without either overcrowding of .class-rooms, or an unsatisfactory 
arrangement of corridors, stairs, etc.” 

‘¢Upon so restricted a site as that contemplated!, light can best be 
secured by making the building very high, higher than for other reasons 
is desirable. 


1“A lot fronting north, of 100 feet front and 100 deep, and enclosed by buildings on adjoining lots 
at the sides and rear, of average city height, say four stories.” (Advertisement.) 


a 


SCHOOL HYGIENE. | 67 


‘*<Jt should be distinctly understood that the committee do not recom- 
mend the plans to which they have given awards as being the best 
designs for a school building, but only as the best plans for a school 
building to be built in a huge box, lacking one side and without a top, 
the sides of which box are about sixty feet high, which seem to be the 
conditions under which school buildings have been erected in New York, 
and in which from 1,500 to 2,500 children have been crowded.”—( Saz. 
Engineer, March 1, 1880.) 

The evil complained of is a general one. New York is not the only 
city where fine new school buildings are erected, with a pleasant outlook 
all around, only to have four-story houses placed on both sides, within a 
dozen feet of their windows, in the course of a year or two. This is one 
of the worst failings of city schools. 


II PLAN AND ARRANGEMENT. 


Many of our oldest school buildings are extremely faulty. In fact, we 
have seen two reformations in school architecture, one dating from the 
publication of Henry Bar- 
nard’s work, in 1839, while 
the other is now taking 
place. The progress made 
within a few years past has 
been as great as at any 
other period, and types of 
edifices, which were un- 
challenged models of ex- 
cellence fifteen years ago, 
are now superseded. 

In schools containing 
several rooms, one of the 
commonest faults used to 
be the parsimony of space, which cut down the room for entries to a min- 
imum, and packed class-room behind class-room without breathing space. 


The effect of this was phi 
greatly to restrict nat- 
sliding doors were very 
ive Class | Ztooms. 

heavy Greek entabla- 

tures, are still seen on 

some older buildings, Plan _ Sane fauti. 

the former serving to cut off a certain part of a light, the .atter taking 


Plan of Schoot-house illustrating exeessiaa 
CON act ness. 


popular: it may be 
feared that they still are 
in some places. Spiral 
stairs were admired. 
Architectural features, 
such as colonnades and 


68 SCHOOL HYGIENE. 


up space in the wall which ought to be devoted to windows. Excessive 
height is a fault which is only just beginning to be remedied. It arises 
partly from a false taste in archi- 
tectuie, partly from the expensive- 
ness of land in cities. 

An instance of the excessively 
compact style of building is given 
in the illustrations (Figs. 1 and 2), 
which are taken from the Report 
of the New York State Board of 
Health for 1881 ; also in Fig. 3. 

Glass sliding doors are sup- 
eg 3 posed to assist in lighting rooms 

which are faultily lighted in other 
respects. They are far less effect- 
ual than is thought. A person 
standing in the inner room looks 
out through the glass doors upon 
well lighted rooms, and thinks the 
light he sees is entering the room 
where he stands—a false impres- 
sion, which should be corrected 
by looking the other way. Light 
thus transmitted is nearly horizon- 
tal in direction, and has very little 
Plan of Schoot, Fhiladelphian effect in brightening the page ofa 
a book lying on a desk. Glass also reflects some light, and absorbs 
some. In short, light thus obtained is not good light for the purposes 
of study. The rooms in Fig. 3 have glass partitions. | 

Another common fault in plan is to have one of the rooms of such 
dimensions that it is impossible to light it advantageously. Such very 
large rooms form an essential part of many high schools, even of modern 
construction; they are used as rooms of assembly, and also as the gen- 
eral study rooms, each pupil having a desk there, and only leaving it as 
occasion offers to go to small recitation-rooms. Such rooms are usually 
lighted from the right and left sides. ‘The width between the windows 
is sometimes as great as seventy feet. The great distance of the windows 
from the central parts of the room is a marked disadvantage. Twenty or 
twenty-five feet is as far as a desk ought to be from the window. 

Associated with this fault,—or independently,—may be found a defi- 
ciency in the size of recitation-rooms. It seems to be supposed that 
these places do not require as much space as ordinary class-rooms, the 
fact being, that they are apt to be in use about all the time, and therefore 
are in no way to be excepted from strict requirements. When looking 
for instances of bad ventilation and overcrowding, one should not omit to 
visit these rooms. The allowance of cubic space for each scholar will be 
mentioned later. 


Directors 


Ftoor 


Lohhy anor Stairs 


SCHOOL HYGIENE. 69 


A type still in vogue, which has some decided merits, may be called 
the four-square plan. It contains, on each floor, four rooms and a corri- 
dor: the corridor runs from front to rear, and the rooms are in pairs to 
right and left. There is a stair- 
caseinfrontand rear. Each room 
is lighted from one side and the 
rear of the scholars: each room 
is a corner room. The type 
which is likely to supersede this 
one is based on the wish to give 
more light and ventilation in the 
corridors. Both are illustrated 
(Figs. 4 and 5). It would be 
rash, however, to point to any 
one plan as likely to have exclu- 
Sive success. 

The objection to spiral stairs is, that the tread is very narrow on the side 
next the wall, and a careless person easily gets a severe fall. The tread 
should never be wedge-shaped. It is a good plan to break up a flight of 
stairs by placing a landing half-way, with a full turn. Both stairs and 
corridors must be well lighted. The steps must be easy to ascend. 

It is desirable to build stairways as nearly fire-proof as possible. They 
may be enclosed in brick walls, so that fire from the main edifice will 
reach them with difficulty. One staircase should be placed at each end 
of the building, so that no room need be cut off by smoke or flame at the 


Fig... 


outbreak of fire: it will be easy to go a step further, and place them out- 
side, or partly outside, of the building, for more complete isolation. If 
the framework is of iron, the treads may be of hard wood, which makes 
them for all practical puposes fire-proof. 

These precautions are among the first to be taken against fire—we 
might say against panic, for the danger to life from fire, in a school 
where children are orderly, is scarcely to be thought of. A thousand 
children can be got out of a large school within two minutes of an alarm 


70 SCHOOL HYGIENE. 


from the principal. They say it can be done in less time; it depends, 
however, on having the children exercised in a special * fire-drill,” the 
sole object of which is to pass them out as quickly as possible. In the 
best schools this drill is given wethout warning once a month. 

Further precautions against fire may be taken: they ought not to be 
limited, however, to prevention of combustion, but should include some 
means for carrying off smoke, which is so apt to cause panic. To this 
end, it is proposed, by the chief engineer of one of our large cities, to 
have a large valve, easily opened, at the roof, so as to draw out great quan- 
tities of air or smoke. There may be also extra flues, built in the parti- 
tion walls, communicating with such floor spaces or wainscot spaces as 
may be supposed likely to be the seat of fire. The flues will not afford a 
supply of air to the flame, but will only carry off the smoke and gases 
instead of letting them come through the floors. ‘The writer does not ex- 
press an opinion upon these suggestions, but they rest on good authority. 
Fire-proofing beneath the floors with layers of plaster is certainly to be 
recommended ; also, the practice of bringing the floors close up to the 
walls, thus cutting off the connection between story and story, which is 
so often the means of transmitting a fire with surprising rapidity to the 
upper stories. Perhaps the chief benefit of all these precautions, as 
regards safety of person, lies in the feeling of security against sudden 
conflagration, which will give confidence in the moment of alarm to some 
teachers who might otherwise be overpowered by sudden dread. 

There are some buildings in most cities which were never meant for 
schools, but which are crowded with poor children, whose danger would 
be imminent in case of fire. A so-called fire-escape, placed on one of 
these wooden traps, affords a possible means of safety, but, for the most 
part, a good staircase in a well built school-house is the best *‘ fire-escape.” 

The passages to be passed through by the scholars in reaching the door 
should be wide ; the outer doors should swing towards the street. There 
should be two doors at least,—one for each staircase. 

The competition for prizes for model school-house plans, which took 
place in 1880 in New York, has already been mentioned. The condi- 
tions upon which the committee of award based their judgment deserve 
to be quoted. In their opinion ‘‘a public school building to be erected 
in a large and densely populated city, should possess the following quali- 
fications, viz.,— 

‘J. At least two adjoining sides of the building should be freely exposed 
to light and air, for which purpose they should not be less than sixty feet 
distant from any opposite building. 

‘¢TJ. Not more than three of the floors should be occupied for class- 


rooms. 
‘TIT. In each peterson not less than fifteen square feet of floor area 


should be allotted to each pupil. . 
‘‘TV. In each class-room the window space should not be less than 
one fourth of the floor space, and the distance of the desk most remote — 
from the window should not be more than one and one half times the 
height of the top of the window from the floor. 


SCHOOL HYGIENE. 71 


“V. The height of a class-room should never exceed fourteen feet. 

** VI. The provisions for ventilation should be such as to provide for 
each person in a class-room not less than thirty cubic feet of fresh air per 
minute, which amount must be introduced and thoroughly distributed 
without creating unpleasant draughts, or causing any two parts of the 
room to differ in temperature more than 2° F., or the maximum tempera- 
ture to exceed 7o° F. This means that for a class-room to contain fifty- 
six pupils, twenty-eight cubic feet of air per second should be continu- 
ously furnished, distributed, and removed during school hours. 

“<The velocity of the incoming air should not exceed two feet per sec- 
ond at any point where it is liable to strike on the person. 

“VII. The heating of the fresh air should be effected either by hot 
water or by low pressure steam. 

‘““VIII. The fresh air should be introduced near the windows; the 
foul air should be removed by flues in the opposite wall. 

“TX. Water-closet accommodations for the pupils should be provided 


on each floor. 


‘¢X. The building should not occupy more than half the lot.” 
The only comments by way of exception that need to be made upon 
this are, that in VI it seems hardly possible to expect a temperature vary- 


ing only two degrees all overa room, if the difference between ceiling 


and floor is intended to be included; and further, that the method of intro- 
ducing fresh warm air, etc., given in VIII, is not the only desirable one, 
as will be shown under ‘ Ventilation” later in this essay. In No. IV 
the size demanded for windows is based on the requirements of city 
architecture. , 

In other respects the recommendations deserve unqualified approval, 
as embodying the chief sanitary requirements in a city school-house. 

Fleighi of School Buzldings. Not merely on account of danger from 
fire, but for reasons affecting the health of pupils, excessive height has 
been, within a few years past, much spoken against. It seems desirable, 
on the whole, to limit the height to three stories, of which the first two 
should contain most of the school-rooms. The reasons for this restric- 
tion are such as apply chiefly to girls of the age of fourteen and upwards ; 
more especially, to young ladies in normal schools and seminaries. Not 
to enlarge upon this point here, it is well to notice the unwillingness of 
such girls, if placed in the upper story, to descend to the play-room or 
yard for recess. The climbing of many flights is an evil which may 
come about in another way, viz., when scholars study in one story and 
descend to another for each recitation. In such cases the need of con- 
sulting teachers before building isevident. The plan of the house should 
be made to depend on the plan of study, and architects can seldom fail 
to gather some useful information from those conversant with the uses to 
which their work is to be put. 

A point to note in conclusion is the smallness of the yards allotted for 
the children’s play in American cities as compared with what is found in 
Europe. 


72 SCHOOL HYGIENE. 


III. VENTILATION AND HEATING. 


This is one of the chief topics, and one of the most difficult, connected 
with School Hygiene. 

It is comparatively easy to build a convenient and spacious house: the 
requirements are well known, the cost is tolerably definite, for a given 
place and time. The problem of merely heating a given space is also 
one of moderate difficulty. But ventilation is a matter about which a 
general opinion is hardly yet formed, and the cost of which is very vaguely 
known. People in general are not yet agreed as to what constitutes good 
ventilation—how much fresh air per hour is required. 

Between a barely tolerable system, eked out by opening windows, and 
a system which really furnishes a supply of from thirty to sixty cubic feet 
of fresh warm air per head and minute, there are many shades of differ- 
ence. Few havea mastery of the somewhat complicated questions in- 
volved; very few have seen successful and logical experiments made; 
and many are called on to act as judges—to act upon an opinion which 
they cannot have formed. 

Amount of Fresh Air and Cubic Space Required. It is unfortunate 
that authorities differ so widely on these points. The New York Metro- 
politan School Board sets the minimum allowance of space per head at 
from 7o to 100 cubic feet, according to age. Fortunately, this does not 
represent the general practice in that city,—though, to the eye, the appear- 
ance of many infant classes suggests the idea of sardines in a box. Most 
authorities would wish to double these figures, at least. 

According to recent inquiries in Boston, there i§ no corresponding law 
or regulation ; but it is customary to build rooms for fifty-six pupils, with 
an allowance usually ranging from 160 to 220 cubic feet per head. Prof. 
Kedzie, of Michigan, claims 300 cubic feet; A. C. Martin, 220; various 
German states, from 120 to 284. The Conseil Supérieur a Hygiéne Pub- 
lique, in a recent report to the Belgian Ministry of the Interior, recom- 
mends a minimum of 63 cubic metres per head, or about 240 cubic feet, 
a space which requires the unusual height of 44 metres, or about 14 ft. 10 
in. The high position of the sanitary service, especially as regards 
schools, in Belgium, lends weight to their recommendation. 

It is the writer’s belief that it is desirable to limit the size of classes to 
forty (40) pupils. Experts in education recognize the gain that accrues 
to the individual scholar from such limitation. If we base the calcula- 
tion on this figure, we have more liberty of choice between large and 
small rooms in making our plan fora building. The advantage of space 
is twofold ;—it enables us to introduce large volumes of air, fresh and 
warm, without danger of draughts; and it gives more value to the prac- 
tice of airing-out the room by windows at recess times, since a large 
roomful of fresh air lasts longer than a small one. But there is such a 
thing as too much space, entailing difficulties in regard to discipline and 
teaching, and making it hard to secure good light. For example, a class 
of fifty-six, with an allowance of 250 cubic feet each, requires a room of 


SCHOOL HYGIENE. 73 


the capacity of 14,000 cubic feet, or 27 feet wide, 37 long, and 14 high, 
dimensions which can hardly be profitably exceeded, if indeed they are 
not too great already. 

As regards the amount of fresh air to be introduced hourly, it is desir- 
able to found our ideal upon the basis of Parkes & DeChaumont’s views, 
which represent the best authority. By depending upon the testimony 
of their senses as to whether rooms were ‘‘close” or ‘‘ fresh,” these 
authorities reached the conclusion that it is not desirable to allow the 
amount of carbonic acid in air to exceed the proportion of 6 parts in 
10,000. Any higher proportion seemed to be attended with perceptible 
closeness. 

Now, assume that fresh air from out of doors contains 34 parts in 
10,000, which is a trifle below the usual rate. A room of the capacity 
of 10,000 cubic feet, freshly filled with this air, and tenanted by one man, 
would receive from his lungs an addition of 24 cubic feet of carbonic acid 
in 44 hours, raising the total to 6 cubic feet. If, then, 10,000 cubic feet 
will last 44 hours, the supply for one hour should be 2,400 cubic feet, or 
for one minute, 40 cubic feet. 

The usual assumption is, that ‘‘ fresh” air contains 4 parts, not 33, in 
10,000. If so, the hourly requirement is about 3,000 cubic feet, or 50 
per minute. Billings increases this to60. If an average school-room of 
the better class contains an allowance per scholar of 200 cubic feet of 
space, there would be a necessity for renewing the air completely every 
four minutes, or fifteen times in an hour. This requirement, however, 
is intended to apply to rooms used day and night, such as barracks. For 
school-rooms, the.amount may be less, owing to the opportunities for 
frequent airing, and the total disuse out of school hours. The writer 
agrees with Dr. Billings in the belief that, for schools, the allowance of 


from 25 to 30 cubic feet per minute and head will answer all needful 


purposes, if supplemented by occasional airing-out during and after 
school. 

It is evident that if air is to be introduced so rapidly, there should be 
a liberal allowance of room, in order that the incoming air may not be 
felt as a draught. The outgoing air, by the way, is rarely felt; but a 
very vigorous draught may be appreciable two feet from the register. 

Do children require a smaller allowance than adults? or, Do small 
children requtre less than large ones? 

One answer, in the affirmative, is derived from the estimates of the 
amount of CO, exhaled at different ages. Breiting gives it, for girls aged 
seven or eight years, at a little over 10 litres per hour; at the age of eight 
or nine, 12 litres. If engaged in singing, it is 16.7 for the latter age. 
Boys aged twelve or thirteen expire 13 litres; during singing the amount 
risesto17. Scharling gives, for the age of ten years, close upon 10 litres ; 
for a boy of sixteen, 17.4; for a young woman of seventeen, 12.9; for 
adults, a little more. Pettenkofer & Voit give 16.8 for a weak man, and 


_ 22.6 for a strong man. 


It would appear, then, that there is a decided difference to be allowed 


74. SCHOOL HYGIENE. 


for. Primary pupils expire less CO, than high school pupils, in the ratio 
of 2 to 3; or perhaps the difference is still greater. Ifa room ought to 
contain the cubic space of 250 feet per head for larger scholars, it need 
contain only 180 for the same number of small scholars. In other words, 
forty large and sixty small scholars can be accommodated in an equal 
space. : 

This estimate, however, is admissible only on the supposition that the 
ventilation is efficient. In case of defect, or apprehended defect (and this 
covers a wide ground), the young children should have equal room with 
the older ones, on the ground of their comparative inability to cope with 
the deleterious effects of bad air; also, because in contracted quarters the 
danger of draughts from windows is greater. It has been said that chil- 
dren need a proportionately large allowance, ‘*‘ because metamorphosis 
of tissue goes on more rapidly in them.” We have two means of esti- 
mating the amount of tissue-change,—the quantity of CO, exhaled, and 
the quantity of food consumed. On the whole, the latter item is suffi- 
cient for the argument, and may be believed to represent the amount of 
change of tissue very well. It is quite evident that, though boys of fif- 
teen may consume as much food as men, children of eight do not. A 


supply of air, then, which would be liberal for a large boy, would be 


more than liberal for a small child. The degree of allowance to be made 
is a point upon which distinguished authorities differ. DeChaumont 
would place three times as many children of four or five years in a given 
room as youths of fifteen or sixteen, while ‘Billings would allow very 
nearly the same amount for children of all ages. 

Dimensions of Ventilating Apparatus. Let us suppose the case of 
a school-house to be planned for thorough ventilation. It is assumed that 
all the air to be extracted is to be carried by flues through the roof. We 
will first consider the flues for extraction. The resistance offered by 
friction is of great importance, and should lead us to make the flues of 
liberal size, as straight as possible, and smooth internally. A flue of less 
than eight inches internal diameter is not worth much. The inside 


should be finished in smooth plaster, or, better, with sheet metal; never — 


with rough brick unless very large. Angles check momentum very 
greatly ; so do horizontal passages. 

Suppose a single room to be ventilated by a single brick flue, straight 
and well made; and suppose the only force to produce a current is the 
warmth of the air leaving the room at 68°. It is probable that if the flue 
is of moderate height, with no fire, the upward draught will seldom ex- 
ceed the rate of two feet per second. An average of two would bea 
liberal allowance. If there are fifty-six pupils, the chimney is expected 
to discharge 28 cubic feet per second, and in order to do this, it must be 
at least 14 feet in sectional area, or about 4 by 34 feet inside measure. 
The register opening to this flue should beat least as large. (The reader 
may try to form an idea of this by measuring the dimensions on the 
wall.) 

Not to speak of the register, such large flues cannot be introduced into 


—" 


2 


SCHOOL HYGIENE. 75 


a building already finished, and can hardly be thought of in a new plan. 
There is, indeed, no necessity of so large a shaft if we provide a some- 
what different arrangement. 
If convenient, we can cause 
the furnace-smoke to be car- 
ried up this flue in a cast-iron 
pipe, thus increasing the heat, 
and possibly doubling the ve- 
locity. In large buildings, 
moreover, the whole system 
must be centralized, and this 
is done in two ways,—first, 
by conducting the foul air 
from each room by long tubes 
to a central heated chimney ; and second, by grouping rooms so that they 
discharge their foul air at once into the chimney, without intervening 
**ducts.” The latter is the 
plan of the Bridgeport, Conn., 
high school, to be described 
presently. 

Three illustrations (Figs. 
6, 7, and 8) show how the 
| ¥%.@ first plan may be carried out. 
It is to be observed that they 
all imply the expenditure of 
extra heat to force a draught ; 
also that in No. 6 the heat is 
applied in a chamber in the attic (which may be of wood lined with sheet 
metal), while in the others it is imparted by the smoke-flue of the furnace. 
The most economical plan 
of the three is stated by 
- Planat to be the last; the 
least economical, the first. 
The Bridgeport school 
plan is illustrated in the 
next plan (Fig. 9). It is 
ventilated by two large, 
brick shafts, which curve 
and meet in one at the 
attic story. In their up- 
ward course they pass di- 
rectly by each school-room, and take foul air by one large opening from 
each. These same shafts also carry the tin flues for the hot air supply 
of the rooms, one such flue for each room. The heat lost from the tins 
goes to keep up the heat of the shaft, and increase the ‘* suction” power. 
The smoke-flue is utilized in the same way, and there is a ‘suction coil” 
for extra heat in the upper part of the flue. 


76 SCHOOL HYGIENE. 


With but one inlet and one outlet, there was need for special care in 
planning the position of the registers. The plan adopted seems to be 
quite successful in distributing the air and equalizing the temperature. 
The inlet for hot fresh air is near the ceiling: the current travels towards 
the windows: a descending current near the windows, originating in the 
cooling effect of the glass, continues the movement, and finally there is 
a strong outward movement of air at the inner corner of the room on the 
level of the floor. Something like a circular movement is thus produced. 
In the diagram (Fig. 10) arrows are introduced at points where currents 
are felt, and the intervening points may be filled in by the reader’s judg- 
ment. The figure represents the room in section, with temperature taken 


MOUTH OF FURNACE*ALUE 


EXLES FLOR ATR 


Ei 9. 9. 


MITTIN LL MRO DOP LS 


SUCTION~= COIL 


<Soullly 
\\) 
<> 
\} 
wit 
Ww 


Ales FE Aine 
bine be COLO Al 


BRLDGEPORT.«.CONN.,HIGH SCHOOL. . 
VERTICAL S#LEION. 
simultaneously after the apparatus had been in operation forty-five min- 
utes. Similar arrangements have been since made, to the knowledge of 
the writer, in schools in Auburn, New York, and Newton, Mass., with 
good success. 
The orifice for the exit of foul air ought to be a good deal larger than 


that for the inlet of fresh air. In examining Fig. 9, the reader is desired 
to make the correction mentally. 


SCHOOL HYGIENE. 77 


The use of steam power as a ventilating agent is not a novelty in other 
public buildings, but in school-houses it has been tried, so far as known 
to the writer, only in Boston, and that within a few weeks past. The 
experiment is one which it is very desirable to make, by way of testing 
its economical value. The arrangement consists of a fan placed in the 
space below the ridge-pole, within a box, propelling the air upwards 
through the cupola, and exhausting by good-sized flues from below. The 
motor is a high-pressure engine in the cellar, which seems to require 


Fig. 10. 


BRIOGEPORT HIGH SCHOOL 
Verizeal Section of @ Room, Soninp Temperatopes 
at height of 1 inch SP feet G feet 12:feet_from fluar 


from twelve to fifteen tons of coal during the winter, and the constant 
presence of an engineer. A new form of engine (‘‘ vacuum engine’’) is 
proposed, requiring no separate fire, and run by jets of steam from the 
boiler which heats the school, at an extremely low pressure. No tests 
for carbonic acid have. been made, but the anemometer test, applied in 
two schools, gave a rate of discharge equivalent to twenty-four cubic feet 
per head and minute, which is about as much as we can ask for. The 
expense of introducing the appliances is stated as moderate ; flues, not to 
be considered, being required in any case; vacuum engine (no boiler 
required), about $500; and fan, something more, besides cost of gearing 
to transfer power from cellar to attic. In one school a certain amount of 
rumbling noise is heard (but not complained of), due to vibrating motion 
in the attic, the apparatus having been introduced not as part of the 
original plan, but after the school was built. In the other building 
scarcely any sound was heard. 

The arrangement of flues for such a plan has nothing peculiar. It 
requires chiefly the avoidance of angles, or rough and narrow flues, and 
is represented in figure 6, the fan being placed at ****, just below where 
the cupola is set upon the roof. 

No system for exhausting air by hot flues or by steam power should be 
introduced without providing for the introduction of a corresponding 
amount of fresh-warmed air. Hence it follows that ventilation and heat- 


78 SCHOOL HYGIENE. 


ing constitute parts of one general problem, and that the same mind 
should plan both. 

“¢ Indirect” heating is the only kind worthy of our consideration. In 
cases where stoves are set in school-rooms, they should be made indirect 
heaters by the use of screens, as is hereafter described. For larger build- 
ings, steam heat, by means of coils arranged in boxes in the basement, is 
probably the best. Auxiliary coils may be placed in entries, but not, as 
a rule, in school-rooms. Ventilation cannot be had without some in- 
crease in the bills for fuel. There is reason, however, to think that the 
amount of increase is not so great as might appear. In our worst venti- 
lated schools there is a good deal of warmed air let out at windows, in 
an unsystematic way. 

Good ventilation implies that cold draughts from open windows are 
done away with: hence a lower degree of heat in the room is sufficient 
for comfort. It also implies a rapid change of air, with equalization of 
temperature, so that the feet are kept warm: this also enables us to be 
comfortable at a low temperature. A third point, bearing in the same 
direction, is the greater activity of the circulation and of the change of 
bodily tissue, and the consequent increase of bodily warmth in fresh air. 

The writer has at least twice found opinions strongly expressed in favor 
of the results of ventilation. Once inanew primary school at Springfield, 
Mass., where the teachers agreed that they could get along with the ther- 
mometer some degrees lower in their new, well ventilated quarters, than 
formerly was the case in close rooms. The other instance points indi- 
rectly in the same way. In the new building of the Massachusetts Insti- 
tute of Technology, with nearly perfect ventilation, the quality of the 
work performed is said to be decidedly superior to that which was done 
in the old building, which has no system worth naming. The ventilation 
in the new Institute building is very successful. It is effected by a fan in 
the basement, which forces air through openings in the inner walls of the 
rooms at a high point, the air escaping by flues in outer walls at low 
levels. The allowance per hour and head is 1,500 cubic feet in lecture- 
rooms, and from 2,000 to 4,500 in laboratories of various kinds. The 
analyses of air gave from 4.87 to 5.23 parts CO, in 10,000, in a room 
which was half full of students. The estimate for a full room would be 
from 7 to 8 parts per 1,000. Corresponding analyses in the old building 
gave from 9g to 12.34 in a room with doors and windows open, half full ; 
if filled it would probably stand at 21 or 22 in 10,000. Prof. Wood- 
bridge’s estimate of the fuel burned last winter is 307 tons for the old and 
404. for the new building, and some allowance is to be made for the fact 
that all the boilers are situated in the cellar of the older building. Both 
are of nearly the same size, and are equally used, and for the same pur- 
poses. 

However encouraging these results, it is seen that perfection is not yet 
reached. By way of comparison, a few selected data are given, showing 
the number of parts in 10,000 of CO, in the air of various localities. (See 
table.) ; 


SCHOOL HYGIENE. 79 


It is probable that the bad air of German schools is one cause of the 
prevalence of near sight and other defects of vision. 

The standard of 6 per 10,000 is not likely to be reached in schools at 
present. Perhaps we shall have to admit the practical justice of Prof. 
W. R. Nichols’s remark, that 10 in 10,000 is as low as we can expect to 

find in schools with fair ventilation. 


AMERICAN SCHOOLS. 


No. of Parts CO2 
examined, | 17 1/000. eae 
0 a 1875 9 12.2 E. Thompson. 
RT eae gsc rc sesccs 1870 40 14.5 A. H. Pearson. 
CO ES ee eee es 1875 III I1.9 Draper & Nichols. 
a 1880 39 15.6 W.R. Nichols. 
MeIGHIPAN......... ict FA ee 46 22.9 R. C. Kedzie. 
New York city........-.....+ 1873 17 20.8 H. Endemann. 
MUP MES fo ok ee eee 1883 8 17.5 Prof. Hills. 
GERMAN SCHOOLS. 
ET afc) 39.9 O. Krause. 
Wilhelm’s Gymnasium in March.............. 55.8 Oertel. 
¥ m July. . 2): NGS, Ped 22.9 
Celle, Gymnasium, various rooms.............. 20.50 Baring. 
Celle, Volks-schulen, most rooms.............- 90 ur 
es a MUMRIIVG TOOTH 6 5 5! o)<)0 vein cla o)s ys’ s 120 cE 


Much has been said regarding the proper position for outlets and 
inlets for air. One false view may be corrected at once,—the notion that 
carbonic acid gas is the agent that is chiefly noxious, and that this gas 
seeks the lower levels. It is not specially dangerous in quantities found in 
schools—the animal vapors from skin and lungs are more so—but it repre- 
sents the degree of organic pollution fairly well. It is not found chiefly at 
alow level. Ifthere is any difference, the upper levels are sometimes more 
impregnated, owing to the breath rising in a cool room; but the differ- 
ence is small, and, in a room with rapid ventilation, not distinctly trace- 
able. The air from the pupils’ lungs may be assumed to be distributed 
through the apartment rather quickly. The process of ventilation then 
becomes, not a removal of the exhaled air, but a dilution by the introduc- 
tion of large quantities of fresh air. 


80 | SCHOOL HYGIENE. 


A test for carbonic acid is not easily made in a way to satisfy scientific 
demands, but an approximate test can be made in a minute by an un- 
skilled person. An ounce of fresh lime-water in a ten-ounce bottle of 
the air to be tested, shaken vigorously for half a minute, will indicate a 
fair degree of purity, if it is not distinctly made turbid.- One should have 
a little practice, even at this simple operation. 

The writer has endeavored to make a convenient and portable appara- 
tus which will give an indication of the number of parts in 10,000, within 
a range of error not exceeding one part. ‘To some extent the instrument 
is successful. It is based on Lange’s method. A series of bottles’ of 
known size was chosen, graded from large to small, and fitted in a 
wooden frame. The whole apparatus is carried to the room to be tested. 
The bottles have been previously filled with water, and when inverted the 
air fills them at once. They are stoppered, and carried to the laboratory, 
where a given amount (say one half ounce) of lime-water (chosen as 
being less liable to change than baryta-water) is introduced into each, 
and also a few drops of a solution of phenolphthalein, which gives a rose 
color to the lime-water. By shaking for a good many minutes the car- 
bonic acid is made to neutralize the lime; the approach of complete neu- 
tralization is marked by the fading of the rose color; and when satisfied 
that the process has gone on long enough, we select the largest bottle that 
shows the complete change, and say,— 

The air in this bottle measures (say) 10 ounces; it contains enough 
CO, to neutralize (say) 4 ounce of lime-water: how much COQ, is here? 
and how many parts in 10,000 parts of air does it stand for? 

The calculation is of course made previously for each bottle, so as to 
reduce the labor of a test to the mechanical operation. The act of shak- 
ing is fatiguing, and the charging of the bottles requires some practice, 
and a well graduated tube. No figures are here given, but by a com- 
parison with simultaneous analyses made by Pettenkofer’s method, an 
encouraging degree of accuracy has been observed. The point of diffi- 
culty in this and similar processes is to determine when the carbonic 
acid is to be considered as having been fully taken up by the lime. This 
fault seems to attach to Mr. Owen’s ingenious process, given in Billings’s 
‘¢ Ventilation and Heating.” 

Source of Supply of Air. The purity of the source must be carefully 
guarded. A wooden duct is the usual means of conveying the air across 
the cellar to the furnace. Such ducts easily open at the joints, and let in 
cellar air: hence painting from time to time may be useful, unless tin be 
substituted, or galvanizediron. The interior should be accessible in some 
way for cleaning, as dust cannot but accumulate with time. The inlet, 
out of doors, is to be guarded with a wire screen, and is so situated as 
to be out of the way of mischievous persons. Bad smells are sometimes 


noticed in a school, which enter through this channel. It is hard to tell, — 


in certain neighborhoods, just where to place the opening. The ground 
is damp; the air at ten feet is odorous for various reasons; and at thirty 
feet the smoke of neighboring chimneys is blown into the inlet ;—it is 


SCHOOL HYGIENE. 81 


usual, however, to make the cautionary remark that malaria and damp- 
ness linger near the ground, and, as a rule, ten feet from the ground is a 
good place. . 

Scrupulous cleanliness of the cellar is necessary. If there are water- 
closets there, they had better not be near the ducts, nor even in the same 
division of the cellar, since the ducts are provided with doors which are 
liable to be left open contrary to orders. The misuse of such valve-doors 
is one of the crying sins of janitors. Many amaster has a perpetual war- 
fare with this functionary on account of this. The janitor’s object, first 
and last, is the saving of coal in order that he may receive credit for 
economy, and his habit is to close the outer valve, opening the one that 
leads from the cellar, thus feeding his furnace or coils with cellar air at 
60° instead of the cold air out of doors. In this way the writer has found 
a school-house filled with air which must have passed through the fur- 
nace two or three times, being drawn down through the entries to the 
cellar, and then sent back through the furnace. Excessive heating of the 
air is not so frequent a fault at present as formerly. A report made to 
the Boston school board in 1846 complains that the air sent to school- 
rooms is frequently heated to 500° or 600°. This may be simple exag- 
geration, but there is no doubt that a heat approaching 200° is not un- 
commonat present. Circumstances alter the 
requirements greatly, but for schools by day- { 
light, the range should not much exceed 120° 
F., nor fall much below 80°. In order to 
fulfil this demand furnaces and boilers should 
be made very large. Steam heating is one 
of the best methods. The pressure upon a 
boiler of proper capacity need never exceed 
ten—perhaps it should not exceed five— 
pounds to the square inch, and it should 
frequently run. down to one pound. The 
danger of explosion need hardly enter into 
the calculation if there is good management. ) 

Ventilating-Stoves. A useful apparatus ~ ‘ — 
for aiding ventilation is furnished by a class 
of stoves which are provided with an inlet for fresh air, and a chamber 
for warming it before it is introduced to the room. 

Figure 11 shows a stove having a jacket of sheet metal, a space be- 
tween the jacket and stove, and a fresh-air 
flue, with a valve operated from the room. 
The principle, as regards air-supply, is not 
essentially different from that of the ‘‘ Fire 
on the Hearth,” the ‘‘ Jackson Ventilating 
Grate,” and Galton’s ventilating fire-places. 
The method is practically valuable, though 
the stoves I have seen do not really supply 
Fig.i2. enough air; that is, a stove large enough 


Jacker Space 


Jacke? Space 


| —_—_—> ' A enteraky 
open Winco 


82 SCHOOL HYGIENE. 


to heat a given room does not introduce nearly enough air to vextzlate 
it. The column of hot air is very short, and the velocity moderate. 
Yet, where stoves are to be used, there is an obvious gain in using this 
kind. It ought to be supplemented by a powerful chimney-draught, the 
chimney being made of liberal 
size, and heated by the passage 
of the stove-pipe: an opening 
for ventilation is to be made 
near the floor. In still other 
ways ventilation may be aided 
by the stove-pipe, as will be 
seen from Figs. 13 and 14. 
Figure 12 shows a screen 
(supposed to form a semicir- 
cle) placed by a stove near a 
window, which is opened. 
Figure 13 is like Fig. 11 in 
principle. 
Figure 14 shows how a low- 
er story may be ventilated. 
The last four illustrations are 


from Billings’s ‘‘ Ventilation and Heating.” 

The evaporation of water in connection with heaters is probably useful, 
but the writer is not inclined to consider the matter one of primary im- 
portance. It is successfully 
dispensed with in some of 
the best ventilated new wards 
in hospitals. 

Children often come in 
CRSA i i with cold and damp feet. 
: It is desirable to provide 
some kind of foot-warmer 
in the hall or basement. A 
good one is made of an iron 
plate, 24 or 3 inches thick, 
set on a flat steam-coil. 

Opening Windows. This 
may be regarded in two 
lights, according as the schol- 
ars are at work, or moving 
and exercising. ‘To keep windows partly open seems an absolute neces- 
sity in many school-rooms. In one-roomed country schools, one of the 
first steps in sanitation is to insist on the upper sashes being arranged so 
as to be lowered. An open window is an evil, nevertheless, in cold 
weather. ‘The palliative measure to be recommended is a strip of boara 
a few inches wide placed so as to deflect the current from under the | 
lower sash, and make it pass above the heads of pupils. ‘This isa decided 


Lower Story 


SCHOOL HYGIENE. 83 


mitigation of the draught. It is very often liked in rooms where the 
ventilation is otherwise bad. A tilting sash at the top of a window can- 
not safely be used in winter. Such a sash, however, ought to be placed 
over every room door to enable the occupants to share to some extent in 
the purer air of the entries. There is no question of the good done by 
temporary opening of windows and doors for a minute or two while 
scholars are exercising. The effect may be supposed to disappear in two 
minutes or so; but when combined with a short physical exercise in the 
standing posture, its effect, both moral and physical, is undeniably good. 
In a very carefully conducted school known to the writer, this is done 
every hour, the period of five minutes being allotted for that purpose, 
unless there is a regular recess. At recess time, also, it is the rule that 

no child shall remain in the rooms, but that all shall go to the play-rooms 
under charge of their teachers, the windows in the mean time being 
opened by scholars deputed for the task. These measures, well carried 
out, greatly relieve the condition of a school which has no efficient Sys- 
tem of flue ventilation. 

The ‘* Eureka” ventilator is an opening in the wall to let in air directly. 
It has a valve, and the passage is bent so as to throw the air upwards. 
It is a useful accessory in some cases where a thorough ventilation is not 
planned for. Similar openings are often found behind steam-coils in 
school-rooms. Their utility is delusive ;—they deliver a very small quan- 
tity of air, and are liable to be stopped up by accident, or for the pur- 
pose of keeping out the cold. 

Much has been said of the supposed capacity of cast-iron stoves to let 
carbonic oxide gas pass out through their pores, thus contaminating the 
air with a peculiarly deadly poison. The present weight of evidence 
does not sustain this belief. 


IV. SEWERAGE. 


It is difficult to trace any large amount of disease in schools directly to 
offensive privies or sewers. ‘There can be, however, do doubt that some 
isso caused. The school is often supplied with water from a contam- 
inated well. Bad air and stenches are not always provocative of illness, 
but the common-sense of civilized races suspects them, and there is no 
doubt that they may promote debility, headache, loss of appetite and 
digestive tone, and general depression of vitality ; while in the minds of 
some physicians there is no doubt that dysentery may be caused, and per- 
haps typhoid fever, and that scarlatina and diphtheria may be aggravated 
by exposure to foul air. Pneumonia, tonsillitis, rheumatism, and neural- 
gia are probably to be included. 

Although drainage, as applied to school buildings, is governed by the 
general rules applicable elsewhere, it may yet be desirable to note, in 
passing, the chief of these rules. A certain number of points of more 
special application will be noticed afterwards. 

{n all houses, whether used for school purposes or not, the drain, soil, 
and waste pipes ought to be of iron, visible and accessible throughout 


84 SCHOOL HYGIENE. 


their course, .. possible; without angles, as straight as possible, and 
never horizontal. Soil and waste pipes are to be carried up full size, 
two feet above the house roof, and there guarded against the weather. 
A trap is to be provided for each sink, basin, urinal, or closet, and a 
running trap for the outlet of the drain, with an opening from the drain 
for ventilation, just inside the trap. Safes are to be connected with the 
drain directly. Rain-water leaders are not to be used for any other pur- 
pose, and vice versa. The best trap for sinks is, perhaps, the ball trap. 
Ordinary S traps are often shallow, and are rather more easily siphoned 
than D traps. Traps are to be ventilated by 14-inch pipe leading to the 
general ventilator (z. e., the continuation of the soil or waste pipe) 
above all other inlets. If not ventilated, the omission must be made upon 
good authority. Bell traps are convenient for the floors of urinals, but 
they are rather inefficient unless the seal is made deeper than usual. 

In many towns there is a supply of aqueduct water, but no public 
sewer. In this case the drain usually discharges into a cesspool, loosely 
built, which permits the escape of fluids into the soil. This arrangement 
is satisfactory when there is a good deal of spare land, and when the soil 
is light and gravelly. Ina clayey soil it may be entirely inadmissible. 
If the population is even moderately compact, sewers should be provided 
at once, under peril of infecting the subsoil air to such an extent as to 
influence the air of cellars. City schools are usually provided with” 
water-closets proper, or with flush-tanks or iron latrines. In country 
schools the ordinary privy is almost universal. Good water-closets are 
doubtless the best arrangement, so long as they are kept in order. No 
kind yet invented is free from the danger of derangement. A hopper 
which gives a full and quick discharge of water is probably the best for 
schools. The discharge may be dependent on the movement of the door 
or seat, or may be arranged to occur at once in all the bowls at a given 
signal. 

The flush-tank is a long vault of masonry, over which the seats are 
built. It should have a round bottom and rounded corners. At one end 
is a tap of water; at the other, in the bottom, a plug to let out the con- 
tents. The janitor should remove the plug, and flush and swab the inte- 
rior at least once a day. With proper ventilation there need be no of- 
fensive odors. If placed ina well lighted cellar, it will give satisfaction as 
long as it is carefully attended to ; but such is human nature, that we may 
expect to find a certain proportion of cases in which due care is not given, 
and consequently dissatisfaction is felt. There is a great difference of 
opinion among intelligent heads of schools upon this point, some being 
unwilling to tolerate these arrangements under the house-roof, while 
others are strong in support of them. On the whole, it seems better, if 
we cannot be sure of the future character of the service rendered, to place 
all of them out of doors. A flush-tank will not freeze in the climate of 
New York city if emptied at night. In colder places it may be necessary 
to empty not only the tank (which in any case should be always done), 
but also the pipes leading to it, directly after school. 


SCHOOL HYGIENE. 85 


An unobjectionable apparatus consists of an iron sink coated inside 
with a firm glaze, rising to contact with the seats, and only deep enough 
to hold a few inches of water, with a suitable space above. There should 
be no riser. The whole should be above ground, in a place moderately 
warmed; the water to be drawn off daily, and in cold weather not re- 
placed till the next day. Foran out-of-doors sink, if iron is used it must 
not be supplemented by a wall of masonry built above it, as the contrac- 
tion and expansion of the metal cause a breaking away from the masonry. 

As regards freezing, the writer is informed by the superintendent of 
schools at Springfield, Mass., that it does not occur when the water is 
shut off from the out-door sinks and drawn off. 

A school-house should have one water-closet in-doors, for the use of 
females. A building of two or more stories may properly have one on 
each story, in order to save girls the fatigue of climbing stairs in cases 
where the privilege is desired, and also for the teachers’ use. 

The urinal appears to present a difficult problem; but the whole mat- 
ter lies in two words—non-absorbent surfaces and frequent cleaning. 
One of the best forms is composed entirely of slabs of slate, forming a 
wall five feet high, with a gutter at its foot. The gutter is cut in the 
floor-pieces on which the pupils stand. Upright slabs divide the space, 
in the interest of decency. Slate is almost impervious to moisture, and 
is made quite so by oiling with linseed oil. The apparatus in question 
is usually furnished with a perforated water-pipe, to keep the front sur- 
face of the stone moistened with a sheet of water. The idea is a good 
one, but requires such exactness of mechanical work that the jets are 
rarely in perfect order. It has the further disadvantage of seeming to 
excuse a part of the duty of scrubbing. No portion—side, base, or back— 
should be neglected in this respect. All these surfaces are liable to grow 
foul. The amount of work needed to give thorough cleaning is consid- 
erable, but it is the only way to secure purity. The janitor’s task ought 
to be lightened by having the whole floor of the apartment slope towards 
the gutter, so that the hose can be used freely. Some urinals have a 
raised platform, in order to define the place to stand on. The better way 
‘would be to have a depression, which would equally define the position. 
A monitor, in either case, should stand by to check irregular behavior. 

All complication of structure in these departments should be avoided. 
Concealment of the basin of a water-closet by wood-work is not desira- 
ble, and the wooden seat should be so fitted that it can easily be removed 
for cleaning or renewal. The urinal needs no trough. It should be 
made of materials which are not porous: no metal work is admissible, 
for rust is sure to come, and the animal matter of the urine so saturates 
the rust that it can hardly be soaked out. Paint soon scales off from 
metal. Wood can be protected by paint for a time, and then be- 
comes soaked with urine unless repainted. The writer has seen marble 
used—a material whose absorbent powers may be seen in the large slabs 


used in restaurants, depots, and such places. 
Little need be said about the common privy attached to most country 


86 SCHOOL HYGIENE. 


schools. In many cases this is the last thing attended to. It is practi- 
cally outside of the teacher’s supervision, and one can hardly blame a 
young and modest woman for failing to see that her duty lies in this direc- 
tion. It is generally a first-class nuisance as regards odor, insupportable 
if placed within a convenient distance ; but if set off fifty feet or so, the 
exposure which the pupils undergo in cold or wet weather is a serious 
matter. In perhaps one half of the cases it is out of repair. ‘The accu- 
mulations go on for a year ata time. Finally the walls are covered with 
dirty scrawls; and very commonly the girls’ closet is contiguous to the 
boys’, so that every thing is heard through the partition. 

The remedy for a part of these troubles may be found in a more active 
interest on the part of the school trustee. He can have the place repaired, 
the scribbling effaced with a plane, and paint applied so as to give a 
thoroughly neat look. He should try to have both the teacher and the 
scholars codperate in maintaining a high standard of neatness, securing, 
if possible, an occasional visit from the teacher, and making such him- 
self, so as to insure that no breakage or injury goes unnoticed. 

Most privies are too dark. Two closets in immediate contact do not 
insure a proper and modest degree of separation between the sexes: in 
such a case, the boys and girls should have recess at different times. If 
there are really two separate out-houses, it is well to have them, and the 
approaches to them, separated by a sufficient fence. There ought to be 
plank walks, or raised ways (paved, asphalted, gravelled), to enable the 
scholars to go dry-shod. But the plan which commends itself to the writer 
as by all means the best for country schools is the use of dry earth in 
vaults, emptied weekly, in a shed close to the school-house, and access- 
ible by a short, covered way. It may be thought best to retain the old 
style of privy for the boys, keeping it at a distance from the house as 
before; but for girls and little children it is most certainly desirable to 
have a place which they can reach without danger to health. 

Not to mince matters, the direct exposure of a sensitive part of the 
body to the gusts of a north-east storm is not a thing to be regarded as a 
trifle; in certain states of the system it may be highly dangerous. And 


both girls and small children are sometimes led to slight the calls of | 


nature, to their bodily harm, by fear of exposure to bad weather. The 
plan here suggested is one which may be found illustrated in the report 
of the Connecticut State Board of Health for 1883.1 In that report there 
is given a plan for a country district school, which places both privies 
under the school roof, but at opposite ends of the structure. Difficulty 
in keeping the boys’ place in order (owing to the need of a urinal) is 
anticipated, and there is presented, as an alternative, a plan which con- 
tains only the girls’ closet, as is here recommended. 


The figure appended is taken from that report (numbered figure 1o— 
in the present essay, No. 15). It shows a single school-room with sep- 


arate entrances for the sexes. On the girls’ side at the rear is a small, 


square building, isolated from the main building by an 18-inch passage-— 


1In a paper by the writer of this essay—SECRETARY. 


SCHOOL HYGIENE. 87 


way around it, but intended to be sheltered by the same roof. The detail 
of the construction of such a closet is very simple. It requires a recep- 
tacle, consisting of a brick trough about two feet wide, rounded at bot- 
tom and corners, and coated internally with coal tar to prevent the ab- 
sorption of fluids or gases. The coating is continued over the top of the 
bricks and down the front as far as exposed. The bottom is an inverted 
arch of masonry, bedded in cement and coated with the same, and pro- 
jecting slightly at the outer end to facilitate removal to buckets. Four 
feet is a sufficient depth. The bottom ought not to be so low that water 
from the surrounding land can run into it; and it is better that it should 


be raised above the ground level for convenience in removing the con- 
tents. ‘There should be a bin for dry earth in a sheltered place handy 
for use. Two inches of this earth, finely powdered, are to be spread on 
the floor of the pit at first, and a little sprinkled on daily: a complete 
removal is made at the end of each week. 

The present writer would corroborate the plan here proposed by cases 
which he has recently seen, in which the earth removal system is carried 
out with entire success. An ordinary projection in the rear answers 
every purpose; the chamber ought, however, to be isolated by a narrow 
passage-way, furnished with screened windows, which should be kept 
open. The portable earth-closet may be found useful, but in reality it 
possesses no advantage over this arrangement. 

The only disinfectants required for well arranged water-closets are 
water, soap, and fresh air. For earth-closets, no more than these and 
earth are needed. Privies ought not to become offensive: treatment with 
earth should be resorted to, and if that is thought inapplicable to deep 
vaults, then let the vaults be shallow for the purpose of speedy removal. 
But in cases of existing nuisance, or in epidemics of fever, dysentery, or 
cholera, it is well to be provided with a temporary remedy ; and for this 
purpose, chloride of lime, or corrosive sublimate, as recommended by a 
committee of the American Public Health Association, may be used. 
Chloride of lime has the disadvantage of a strong smell. Whichever is 
used may be prepared by dissolving in soft water chloride of lime (of 
the best quality) in the proportion of a pound to four gallons, or cor- 
rosive sublimate, a pound to twelve gallons. The latter solution is to be 
colored with permanganate of potash (nine drachms) to prevent mis- 


88 SCHOOL HYGIENE. 


takes. Of the former solution, use a quantity equal to the supposed solid 
contents of a vault; of the latter, one fourth as much. 

If used undissolved, one pound of chloride of lime corresponds to thirty 
pounds of the solids; one pound of corrosive sublimate to five hundred 
pounds. Subsequently, chloride of lime may be freely sprinkled over 
the contents daily. A corrosive sublimate solution may be used for the 
same purpose, four gallons a day, made by the following formula: Cor- 
rosive sublimate and permanganate of potash, of each 2 drachms 
(4 ounce), dissolved in a gallon of soft water. This may be kept ina 
tub or crock, not in a metal vessel. Asa precaution in case of an epi- 
demic, wash the interior of the vault daily with this. If green vitriol 
(sulphate of iron) is used, take a pound and a half to a gallon of water. 


V. HYGIENE OF THE EYE. 


During the period of school-life, as is now generally known, certain 
affections of sight increase. It would appear from the uniformity of the 
results of investigations that the increase is a general rule; and most of 
those who have treated of the subject have considered it due, in a great 
degree, to the effect of over-exertion of the eyes in school, more partic- 
ularly when the light is bad and the rooms unwholesome. It is generally 
accepted as proved that near-sight is very liable to be inherited. Far- 
sight (old-sight) is also found in children, and, like near-sight, it increases 
in frequency and degree as children grow older, until somewhere about 
the age of fifteen it begins to be less frequent, and at the age of twenty, 
among students, near-sight decidedly preponderates over far-sight. Dr. 
E. G. Loring has given diagrams illustrating this fact in the case of three 
nationalities,—the German, the Russian, and the American. The ob- 
servers, whose facts are taken for the diagrams, are Conrad, who exam- 
ined 3,036 eyes of school-children in Koénigsberg ; Erismann, who exam- 
ined 4,358 eyes of scholars in St. Petersburg; and Derby & Loring, who 
examined 2,265 eyes in New York schools. The ages in all cases run 
from the youngest to the oldest pupils, including members of superior 
schools, up to the age of twenty. In the German table the percentage of 
near-sighted eyes rises from 1175 in the young children to 627, in the 
oldest; in the Russian, from 13,8, to 43 33, per cent.; and in the Amer- 
ican, from 3} per cent. at six to seven years to 26748, per cent. in the 
twenty to twenty-first year. 

There are a good many other similar series of observations, all agree- 
ing substantially with these, but the German percentages are always very 
much higher than the American. This is not surprising if school work 
has anything to do with the result, for German children in all superior 
schools (real-schulen and gymnasia) are made to do an amount of work 
which is incredible to our school-boys, and with some results to show in 
the way of intelligence, too. German children in America also show a 
decidedly greater percentage of near-sight than American children, 
owing, no doubt, to hereditary influence. In a board-school in London, 


SCHOOL HYGIENE. 89 


Brudenell Carter has lately found nearly ro per cent. ot near-sight among 
267 children. ‘These are the facts, and to most minds they seem to point 
to a tendency in national life which is truly alarming. It is a distinct 
drawback to a person’s usefulness to have abnormal sight; to have to 
wear glasses is a serious drawback for many purposes; and yet Ger- 
many, which is leading the world in education, is far ahead in respect to 
near-sight, and we seem to be following her in both points. 

There are those, however (as Landolt), who lay the chief stres., as 
regards causation, upon general conditions of health, maintaining that 
hardship and poor fare constitute one of the chief causes of near-sight. 
It may be so, and this is not the place to enter into the argument satis- 
factorily ; but if so, how shall we apply the doctrine to the case of Am- 
herst college, where Derby’s strictly accurate statistics show an increase 
from 44%; to 5038; per cent. during the four years course? In Amherst 
the conditions of living are as favorable as can be found. Not only is 
there no ‘hardship and poor fare,” in Landolt’s sense, but the young 
men are under a régime of physical exercise which produces a distinct 
effect in lessening illness during their residence. 

A brief statement of the leading causes, not in any presumed order of 
frequency, is given here: 

1. Inherited tendency. 

2. Study while the system is in a weakened condition. 

3. Study in a bad light. 

4. Study in a bad posture. 

5. Study while the eye or brain is fatigued or congested. 

6. Study in excess at the formative period of life, when the bodily tis- 
sues easily assume a wrong bent. 

These will probably cover the ground, so far as relates to our present 
practical object, pretty nearly. The writer ventures also to offer a series 
of practical remarks in the form of rules at this point, leaving further 
discussion till later. 


RULES FOR USING THE EYES. 


In school work we should require,— 

1. A comfortable temperature, and especially let the feet be kept 
warm and dry. . 

2. Good ventilation. 

3. Clothing at the neck loose. The same as regards the rest of the 
body. 

4. Posture erect ;—never read lying down or stooping. 

5. Little study before breakfast, or directly after a hearty meal; none 
at all at twilight or late at night. 

6. Great caution about study after recovery from fevers. 

7. Light abundant, but not dazzling. 

8. Sun not shining on the desk, or on objects in front of the scholar. 

9. Light coming from the left hand, or left and rear; under some cir- 
cumstances from in front. 


me 


gO SCHOOL HYGIENE. 


10. The book held at right angles to the line-of sight, or nearly so. 
11. Frequent rest by looking up. 
12. Distance of book from the eye about fifteen inches. 


As regards the causes. No. 2 refers especially to the case of conva- © 


lescents after measles, scarlet fever, and other weakening fevers. No. 6 


requires attention on account of some suggestive remarks made by Dr. 
Loring in the report referred to. He enlarges on the comparative neg- 
lect of out-door life, and the unwholesome habits of eating and living 
that are found among German children as contrasted with the free play 
and plenty of fresh air that boys have in our country. He also asserts a 
belief that since myopia is a disease of childhood, and rarely originates 


after the age of fifteen or sixteen, it is desirable to give children little © 


severe study until after they have passed that age. More concretely, he 
points to the life of an English school-boy, with his long hours of foot- 
ball and cricket, as a better ideal than the German plan. 

As regards the rules,— 

Nos. 3 and 4 are intended to prevent the occurrence of congestion of 
the head, which is very likely to injure the eye. A recumbent posture is 
bad for another reason, viz., because it places the eyeball in unaccus- 
tomed positions, disturbing the equilibrium, and deranging the habitual 
action of the eye muscles. 


No. 5. Study before breakfast is usually work done at a disadvantage, © 


since that period is one at which the strength of the system is at a low 
point in many people. If study is done by artificial light, the trouble is 
much worse. 

No. 7. Some persons are unduly sensitive to light, while others re- 
quire an amount which is excessive for the average person. Regard may 
be had to this fact in arranging the pupils. Windows of ground glass, 


if within the range of sight, are annoying on account of a kind of daz- — 


zling effect ; if the sun is upon them, they are intolerable. 

No. g. If light comes from the right hand, the pupil’s hand in writing 
shades his work annoyingly. If from the rear, he derives no direct ben- 
efit from it unless he turns himself so as to get rid of the shadow; this 
is the position required in writing by some teachers. <A front light, from 


a window so high that pupils practically are not aware of its presence, 
is good for the purposes of writing; but such a light can hardly be © 


obtained in a class-room without annoyance. Practically, there must be 


no windows for scholars to face while employing their eyesight upon — 
tasks. This rule also forbids placing black-boards between windows, so ~ 


that scholars are obliged to face a full light while trying to read what is 
written on them. And since the black-board is one of the chief instru- 


ments of instruction, and a large extent of it is held desirable, there is an — 


advantage in restricting windows to one side of a room, so that the strip 


of black-board may run around three sides unbroken, and with every part ~ 


of it in a good light. 
No. 10. The desk lid slopes for the purpose named. It is useful to 
have light frames for holding books in a more upright position while no 


\ 
- 
i 
g 


é. 


4 


SCHOOL HYGIENE. OF 


writing is going on. Some desks are made with a joint in the middle of 
the lid, giving the means of obtaining such an inclined book-holder. 

No. 11. The old rule, which punished all who looked up, must be 
given up. Ifa pupil is restless and does not apply himself, his case can 
be reached in various ways, but not by a prohibition of this sort. 

No. 12. This distance need not be an invariable one at all times. If 

generally observed, it will correct the habit of stooping. In teaching 
penmanship, very great care is needed to prevent the formation of bad 
habits as regards attitudes. The author has seen a whole roomful of 
children writing, with their eyes at an average distance of less than three 
inches from the paper. This exercise must not be engaged in if cloudy 
weather makes the light poor. Ink should be of a kind that gives a per- 
fectly black mark when first put on paper, not the thin, bluish fluid 
which is black the next day. 
_ This is the proper place to mention with condemnation the atlases 
which are often used, crowded with detail in small, delicate letters ; also 
the small, ‘‘ school” editions of large, standard dictionaries, printed in 
type which, though clear, is exceedingly fine. Many school-books of . 
our day deserve much praise for their clear, bold type. The use of large- 
type charts in teaching an entire class is to be commended as avoiding 
the necessity for a certain amount of poring over books. 

Here we may repeat what has already been said about very deep or 
wide rooms. Many such are wholly unsuited for comfort in writing. 

If there is a tendency to near-sightedness, no pains should be spared to 
prevent a child from getting the habit of holding his eyes too near the 
book. The distance of fifteen inches is not great; but a child must sit 
up in order to maintain it. This connects the present topic with the 
question of school-desks, of which it will be convenient to speak else- 
where. The maintenance of a true posture is dependent on true propor- 
tions of desk and seat. When these are obtained, and a child with near- 
sighted eyes is unable to see clearly at the distance named, it is the opin- 
ion of many modern ophthalmologists that he should be furnished with 
glasses just sufficiently strong for the purpose of desk work. At the 
same time he may be prevented from crouching down by the use of an 
apparatus which keeps the head at the distance required. Such an ap- 
paratus can be made so as to give no annoyance, and can be kept per- 
manently screwed to the desk. Forster, in 1883, reported several cases 
of remarkable improvement under this treatment. 

Although this is not a place for discussion of the points involved, it 
may be well to mention that the act of keeping the eyes close to an object 
is held to involve a muscular effort, both in the act of converging the eye- 
balls, and also in the (unconscious) act of accommodating the lens by 
the ciliary muscle, which contributes to the increase of existing near- 
sight, if it does not originate it. The best light for working purposes 
comes from above, and is nearly white. This suggests two points: 

1. Windows throw light very obliquely on distant objects. It is held 
by the best authorities that in general they afford sufficient light only 


ie 


Q2 SCHOOL HYGIENE. 


when the distance from the windows does not exceed once and a half 
times the height of the window itself. This restricts the depth of a room 
to about twenty feet; a few more may be allowed for the width of an 
aisle. In one of the handsomest high school buildings in the country the 
depth from windows to opposite wall is forty feet, which cannot be recon- 
ciled with true principles. 

2. If light from above is to be sought, the upper part of the window is 
most valuable, and should be placed within six inches of the ceiling. 
This greatly improves the illumination of the ceiling, which is itself a 
very important light-giver. The lower part of the windows is not of so 
much consequence. It is desirable that they should not be so low as to 
let in light full upon the face horizontally. If the sill is placed four 
feet from the floor, no serious loss of light occurs. It is usually stated 
that if the surface of window-glass is calculated, it should amount to from 
4 to 4 of the floor surface. Of course this depends somewhat on the 
locality. In order to secure the required amount, one side of the room 
must be made as full of windows as is consistent with the strength of the 
wall. The tint of the walls should be a neutral shade of blue, quite light. 
In general, paper is less cleanly than a hard finish. 

Blinds should keep out the sun, and admit light and air. They are 
often poorly made; the rolling slats get out of order. They should be 
of a light color; natural wood color changes to a dark brown in time, 
but a light green tint is very pleasant, and admits a sufficiency of light 
when the sun is shining on the blinds. Solid shutters are not suitable. 
Curtains ought to be provided. The kind which rolls from the bottom 
is best, for it cuts off the horizontal light, which is often very annoying 
to the teacher as well as the scholars, while it leaves the upper part of 
the window free. If it is thought best to place any windows in the rear 
end of the room, they should be provided with these shades. Or the 
_ windows in that situation may be placed at the height of six or eight feet 
from the floor. 

Projecting ‘‘ architectural features,” as cornices and pillars, are not to 
be allowed to interfere with windows, or lessen the amount of light enter- 
ing. Windows must be square at the top. 


VI. SCHOOL-DESKS AND GYMNASTICS 


Some additional points are here to be given: 

I. Support for the feet. This needs special attention in the case of 
little children. Wooden foot-rests ought to be given when needed. 

2. Curves adapted to the body. The seat ought to be ‘‘ curved,” z. é., 
hollowed. The back in American chairs is usually sloped so as to fur- 
nish an easy support in lounging. Some such chairs are so persuasive 
that one can hardly sit upright in them: this is a great fault, for the 
school ought to teach an upright carriage of the body. ‘The chairs used 
in Germany, though the patterns vary greatly, are commonly made upon 
the principle of supporting only the lower half of the spine, usually by a 


SCHOOL HYGIENE. 93 


short, nearly upright, board. Many of our own chairs might be greatly 
improved by an approach to this pattern, the principle to be followed 
being this, that the back of the chair should fit the person closely at the 
lower part, where the spinal column needs support. Ihave seena young 
lady in a high school suffering a good deal from pain due to the want of 
support at that point, which was relieved by placing a cushion there, 
behind the pelvis. No seat that can be devised is suitable for long con- 
tinued occupancy by healthy children. Their bodily growth is impaired, 
and deformity is caused by the mere want of bodily activity. A cure 
for the crooked spine is not, therefore, to be had by carefully adjusting 
the size of the desk to that of the seat, and by giving the appropriate 
curves to the latter, but by developing the whole muscular system so that 
due support shall be given by nature. The deformities which come 
from this source are more frequent than is thought. Feeble, pale, quiet, 
over-dressed, a class of girls passes you, ‘‘ filing” from room to room. 
You see one in a dozen with rosy cheeks, evidently a country girl. 
Their shoulders are all round, and they have the droop forward which 
indicates a want of muscular vigor and deficient expansion of the chest. 
A part of the impression thus given may be due to the subdued tone and 
manner of the school-room. The same girls, however, ‘stay in at 
recess ;” they ride home in the horse-car; their leisure is spent in piano 
practice, and in going to parties. 

There is a potent remedy for these evils in the hands of school boards : 
it is the practice of gymnastics. In this single measure the entire list of 
evils called ‘‘ school maladies” is attacked by giving increased force to 
the entire physical system. Let pupils in normal schools be first made 
to appreciate the benefits of the system by applying it to them; let them 
learn to discard sundry superfluities of dress, by being taught the com- 
forts of ‘gymnasium dress ;” let plain sense, under the title of hygiene, 
be taught as more important than scientific physiology. If this class of 
persons can be converted, a permanent benefit accrues to all their pupils 
in future. 

But to return to the subject of desks : 

3. In classes, however well graded, great differences of height are 
noticed. In accordance with this, each class-room in a graded school 
ought to have at least two sizes of desks; three are desirable. 

4. Height of the desk. When the pupil sits upright, and the arms 
swing freely, the elbows will be just below the edge of the desk, and 
when bent in writing, will barely clear the edge. Girls require a desk 
from one half to three quarters of an inch higher. 

5. The edge of the desk must come up to a line just over the edge of 
the seat, or must overlap the seat by an inch or two. This keeps the 
child from stooping. 

Nos. 4 and 5 are of importance as tending to prevent deformity. Too 
high a desk raises the right or left shoulder unduly. A desk ata dis- 
tance from the pupil’s seat compels him to take a bad posture. 

What remains to be said of school gymnastics may be said here. A 


q 


good deal may be done with no apparatus at all in the ordinary class- 
room. Light gymnastics, comprising movements of the arms, are to be 
practised daily, more for the benefit of the change and for stimulating 
circulation than for development of body. An hour twice a week will 
suffice for a more thorough course, with a trained special teacher, ina 
room devoted to the purpose. No heavy apparatus is reeommended,— 
light wands, dumb-bells of wood, perhaps small clubs. It has been found 
best for classes exercising together in the Amherst college gymnasium to 
give up the heavy gymnastics altogether; much more so in schools. 
Then there are the ‘‘ free exercises,” including proper methods of sitting, 
standing, lying, walking, running, jumping, as well as exercises in con- 
cert, games, etc. 

‘¢The aim of these free exercises is to call into action in turn the 
greater part of the voluntary muscles of the body; and with an intelli- 
gent, earnest teacher to direct them, there is no end to the modifications 
and combinations that can be made, calling for precision, and strict at- 
tention, and skill on the part of pupils.’ 

A very valuable work can be done at once, with no special apparatus, 
and with comparatively little training, by heads of schools who have at 
command a spare room or a hall with movable seats. ‘The members of 
upper classes can be instructed by him with perfect success in marching, 
facing, and a variety of exercises of too complicated a nature to be car- 
vied on in the school-room. 

There are two present obstacles to the adoption of a complete system 
of training,—the expense, and the want of trained teachers. The calling 
of a gymnastic teacher, in fact, is a laborious one. Butthe matter is one 
of prime importance, especially in our city schools; and teachers may 
aid materially in securing the adoption of a thorough system by trying 
to use the means now in their power. 


94 SCHOOL HYGIENE. 


VII. AFFECTIONS OF THE NERVOUS SYSTEM. 


School life is capable of doing much good, as well as harm, to the 
mental and nervous life of scholars. Over-work, work performed under 
pressure or at bad seasons of the year, work done in a state of anxiety, 
are among the causes of injury. The influence of competition for prizes 
is acknowledged to be bad in a great many cases. 

*¢ Double , “omotions” ought to be watched with care. 

As regards over-work, a change in public feeling has come about of 
late, which has largely led to the abandonment of home study for pupils 
under the age of (about) twelve years, and has cut down the hours of 
attendance at school to five in the day. One innovation of modern origin 
requires to be criticised,—the use of a single session, closing at 1 or 2 
P.M., instead of the morning and afternoon session. There should be 
one long recess in such a session, and arrangements for luncheon may 


1 Dr. J. J. Putnam. 


SCHOOL HYGIENE. 9s 


enter with profit into the consideration of the school authorities, for it is 
unnatural for a growing youth or girl to fast six hours ona stretch amidst 
vigorous exertion of mind. The fact that some have no appetite fora 
lunch constitutes ground for suspecting that the school life or work is 
responsible for the want of appetite. 

It is a serious grievance of teachers and scholars that the time of year 
when the work is hardest is the spring and early summer, the season 
alike of review, examinations, diplomas, promotions, prizes, all of 
which is made more trying by ‘‘ spring sickness” and premature summer 
heats. At the close of a year’s work there should be an approach to 
relaxation of effort. How difficult it is to secure such a relaxation is 
well known to teachers. Many a teacher is ready to faint with fatigue 
before the welcome rest comes. The children do not now suffer so much, 
their work being rather irregular than severe, for the most part, at those 
times. 

On a matter so familiar to the public as mental over-work and strain 

among school-children, not a great deal need be said. It is probable 
that social dissipation does a great deal more harm than school work. 
Girls, of course, need more watching than boys, for they more readily 
give up their habits of out-door exercise, and too often have no in-door 
work whatever to compensate for it. Even among teachers this fault is 
marked. ‘Their toil is an anxious one, and they require relaxation as 
much as any profession, but they too often fail to recognize the need. 
The writer was told by a prominent ‘‘ kindergarten” teacher, who has 
teachers under her and instructs others in kindergarten work, that it is a 
frequent fault among her teachers, as well as her adult pupils, to suppose 
that they could work in the morning in teaching, attend a class in the 
afternoon, and go to parties in the evening, the fact being that in this 
kind of work no teacher ought to consider herself capable of any serious, 
responsible undertaking outside of her kindergarten ; and the kindergarten 
hours are from zzze to twelve o’clock! 
_ Without doubt this is very near the truth. Teachers who have five 
hours’ work a day are to be considered as having done a day’s work. 
Seldom, however, is the work completed in that time, for under the new 
régime a great deal of work is written by the children, and has to be 
looked over and corrected at home by teachers. 

Among positive injuries to the system, and symptoms of injury, the 
following may be named as often due to school fatigue : 

Debility, want of appetite, dyspepsia, sleeplessness, irritability, head- 
ache. Other troubles, of less frequent occurrence, are menstrual anom- 
alies, irritable spine, hysteria, chorea, neuralgia. A case of epilepsy -s 
known to the writer, which recurred after five years of health, in a vig- 
orous youth who overworked himself in competing for a prize in gym- 
nastics. 

Complaints peculiar to females have often been charged to the injury 
received in going up and down stairs. Derangement, including excess, 
painful periods, or deficiency, as well as local displacements, have been 


co 
_. eae 
~ aoe 


96 SCHOOL HYGIENE. 


noticed. It is certain that the existence of many flights of stairs is com- 
plained of, and that young women avoid rooms in the upper stories of 
boarding-schools in many cases. It may be well to give here a summary 
of the evidence collected by Geo. E. Smith, M. D., in 1874, in respect to 
anumber of such institutions. The replies amount to the following, 
substantially : 

Answer No. 1. The complaints named are not usually prevalent: 
there are restrictions upon undue haste in going up or down stairs: 
should prefer to have no dormitories above the second story. 

2. They are very frequent, and are due to this cause. 

3. High buildings are bad if there is carelessness in running up and 
down, not otherwise; improper dress and dissipation are the chief 
causes. 

4. Similar to 3. 

5. Rarely due to stairs; due to dissipation: should prefer two-story 
buildings. 

6. Not due to stairs, but to lacing, heavy skirts, and over-work. 

7. Dress, corsets, and stair-climbing are far more to blame than study. 

§. Stairs are a great evil while girls are dressed as they are now. 

The matter has been touched upon in another division of this essay. 


VIII. CONTAGIOUS DISEASE IN SCHOOLS. 


The diseases intended by the title are diphtheria, scarlet fever, measles, 
and small-pox. 

There is little need to enforce by argument the importance of the sub- 
ject. There is a pretty general feeling that the matter of complaint is 
not an imaginary one. In the report of the Massachusetts State Board 
of Health (ninth) a large number of letters from physicians are cited or 
referred to, all, with scarcely an exception, acknowledging the danger of 
contagion to be real. There is, however, a mass of ignorance and blind- 
ness in the lower social strata which cannot be expected to pay the slight- 
est heed to ordinary precautions for preventing contagion until forced to 
doso. The means for bringing such heedless persons to their duty now 
exist in many places in the form of local ordinances or school regula- 
tions. Such regulations should be something like the following: 

1. ‘he existence of a case of the above named diseases should exclude 
from school all inmates of the house in which it prevails, until compe- 
tent authority decides that it is safe for them to return to school. 

2. ‘Teachers, school officers, or physicians should report cases coming 
to their knowledge at once, whether such cases are in their own school 
or not. The child affected is to be sent home at once, and the parents 
informed of the law. 

3. Contagion being easily spread by pupils after recovery by means of 
clothing or fine particles of epidermis, etc., it is necessary to establish 
rules for disinfection, whether of the premises and clothing, or of the 
patient’s body, the proper performance of such disinfection, and the lapse 
of a suitable time, being ascertained upon good authority. 


American Public Health Association. 


APPLICATION FOR MEMBERSHIP. 


rofession or Occupation, 


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County, 


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scommended by’? 


BPVOVEd -Dy EXCCULIVE COMM LEECE yoececcceccsecsicserssrtirsirtiriiniirinniie 188 
| 1 et a 188 
FL 


Secretary, 


ive name in full. Do not use initials. 
{ust be recommended by two members of the Association. 


THE 


JOHN CRERAR 


LIBRARY. 


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SCHOOL HYGIENE. 97 


4. Evidence of vaccination should be required of all children entering 
the public schools, and revaccination should be recommended to pupils 
at a later date, especially during epidemics of small-pox. 

Contagious affections of the skin, and spasmodic diseases (itch, scald 
head, ring-worm, epilepsy, St. Vitus’s dance, habitual hysteric attacks), 
are deserving of attention, as liable to occur at any time ina city school. 
Teachers should have some knowledge of what is to be done in such 
cases, and should be authorized to complain to school governments. 
The convulsive affections named are, some of them, contagious through 
imitation, and must be excluded unless there seems good reason for the 
contrary course. 


IX. SANITARY SUPERVISION. 


As a corollary to all that has been said, we must consider how the 
facts can be made operative in and upon the schools. In many school 
boards, one person—or a committee—is charged with matters pertaining 
to the health of scholars. For most places this plan is the desirable one. 
In large places, including cities of all sizes, a natural means to this end 
is the appointment of one or more persons charged with the enforcement 
of regulations based on sanitary principles. This plan will soon be 
tested thoroughly ; the only difficulty (or rather, the only question) seems 
to be in relation to the extent of the duties and functions of such officers. 

The cities of Elmira, N. Y., and Boston, Mass., each have an officer, 
a physician, who acts as medical supervisor. In the latter place he is 
entitled ‘‘ Instructor in Hygiene,” the peculiarity of the designation being 
due to certain technical difficulties in the local statutes. Here it may be 
truly said that the field for one man’s exertions being unlimited, and far 
beyond any man’s capacity to fill, it is open to the incumbent’s discretion 
to select the most necessary objects for his first attention. At present 
the inspection of the buildings forms the leading object in Boston. In- 
struction in hygiene is also given by means of lectures addressed to teach- 
ers. That such an officer should be a physician requires no proof. 

How great the opportunity for work may be in certain cases is shown 
by that of the city of Brussels, which (for European ideas) presents a 
model in this respect. This city, with a population of 183,000 and thirty- 
three public schools, has a staff of medical visitors sufficient in number 
to make a weekly visit, with personal attention, to each pupil. In one 
respect their duties go beyond what is likely to be thought advisable in 
America at present,—they give medical treatment to a large number of 
pupils at school. The number thus treated for the three years 1876-’79 
was 446, 732, 1,118, besides which, during the same three years, there 
Were 2,885 cases of dental treatment. Among the chief duties of such 
an officer should be those of inspection of buildings, and of instruction of 
teachers in the principles of hygiene as applicable to their charges. San- 
itary rules may be proposed by him, and he will have a great opportu- 
nity of rectifying errors in sanitary administration due to mere ignorance. 
He will not take from members of the school board their right to be 


98 SCHOOL HYGIENE. 


interested, but he can greatly increase the interest if he knows how to 
use his knowledge of the subject. It need not be said that there are some 
points where the field is already occupied, as the matter of public vacci- 
nation, and other means for guarding against contagion—matters usually 
sn the hands of town or city boards of health. Where these points are 
not thus arranged, the school inspector should have them in charge. 


peat 


TION AND INDIVIDUAL PROPHYLAXIS AGAINST 
oh INFECTIOUS DISEASES. i 


By GEORGE M. STERNBERG, M.D., ANY Ha Ah 
Major and Surgeon U. S. Army. 


AD ASTRA PER ASPERA. 


Bini) 8 By Irvine A. Watson, SEC. AMERICAN PUBLIC HEALT 
Cas | — - a 


All Rights Reserved, 


DISINFECTION AND INDIVIDUAL PROPHYLAXIS 
AGAINST INFECTIOUS DISEASES. 


INTRODUCTION. 


Definition. We are met at the outset by a difficulty growing out of 
the fact that the word dzsexfectzon, as commonly used, has a very differ- 
ent signification from that to which certain recent authors would restrict 
it. Thus, the Committee on Disinfectants of the American Public 
Health Association defines a disinfectant as ‘‘an agent capable of destroy- 
ing the infective power of infectious material.” In the preliminary re- 
port of this committee the reasons for restricting the meaning of the 
word within the limits justified by its etymology, and of our knowledge 
of the nature of ‘‘ infectious material,” are very clearly stated, as follows: 

«*The object of disinfection is to prevent the extension of infectious 
diseases by destroying the specific infectious material which gives rise to 
them. This is accomplished by the use of disinfectants. 

«¢'There can be no partial disinfection of such material: either its in- 
fecting power is destroyed, or it is not. In the latter case there is a fail- 
ure to disinfect. Nor can there be any disinfection in the absence of 
infectious material. . zs he : i 
_ ** Popularly, the term disinfection is used in a much broader sense. 
Any chemical agent which destroys or masks bad odors, or which arrests 
putrefactive decomposition, is spoken of as a disinfectant. And in the 
absence of any infectious disease it is common to speak of disinfecting a 
foul cesspool, or a bad-smelling stable, or a privy vault. 

«¢’This popular use of the term has led to much misapprehension, and 
the agents which have been found to destroy bad odors—deodorizers,— 
or to arrest putrefactive decomposition—antiseptics,—have been confi- 
dently recommended and extensively used for the destruction of disease 
germs in the excreta of patients with cholera, typhoid fever, etc. 

““The injurious consequences which are likely to result from such 
misapprehension and misuse of the word disinfectant will be appreciated 
When it is known that recent researches have demonstrated that many 
of the agents which have been found useful as deodorizers, or as antisep- 
tics, are entirely without value for the destruction of disease germs. 

*« This is true, for example, as regards the sulphate of iron or copperas, 
a salt which has been extensively used with the idea that it is a valuable 
disinfectant. As a matter of fact, sulphate of iron in saturated solution 
does not destroy the vitality of disease germs, or the infecting power of 


1The Medical News, Phila., Jan. 24, 1885, p. 87. 


102 DISINFECTION. 


material containing them. This salt is, nevertheless, a very valuable 
antiseptic, and its low price makes it one of the most available agents for 
the arrest of putrefactive decomposition in privy vaults, etc. 

‘Antiseptic agents also exercise a restraining influence upon the de- 
velopment of disease germs, and their use during epidemics is to be 
recommended when masses of organic material in the vicinity of human 
habitations cannot be completely destroyed, or removed, or disinfected. 

‘‘While an antiseptic agent is not necessarily a disinfectant, all disin- 
fectants are antiseptics; for putrefactive decomposition is due to the 
development of * germs’ of the same class as that to which disease germs 
belong, and the agents which destroy the latter also destroy the bacteria 
of putrefaction, when brought in contact with them in sufficient quantity, 
or restrain their development when present in smaller amounts. 

‘A large number of the proprietary ‘ disinfectants’ so called, whick 
are in the market, are simply deodorizers or antiseptics of greater or less 
value, and are entirely untrustworthy for disinfecting purposes.””* 

The offensive gases given off from decomposing organic material are 
no doubt injurious to health; and the same is true, even to a greater ex- 
tent, of the more complex products known as pfomaznes, which are a 
product of the vital—physiological—processes attending the growth of 
the bacteria of putrefaction and allied organisms. It is therefore desira- 
ble that these products should be destroyed; and, as a matter of fact, 
they are neutralized by some of the agents which we recognize as dis- 
infectants, in accordance with the strict definition of the term. But they 
are also neutralized by other agents—deodorants—which cannot be 
relied upon for disinfecting purposes, and by disinfectants, properly so 
called, in amounts inadequate for the accomplishment of disinfection. 
Their formation may also be prevented by the use of aztisepizcs. From 
our point of view the destruction of sulphureted hydrogen, of ammonia, 
or even of the more poisonous ptomaines, in a privy vault, is no more 
disinfection than is the chemical decomposition of the same substances 
in a chemist’s laboratory. The same is true as regards all of the bad- 
smelling and little known products of decomposition. None of these are 
‘¢ infectious material,” in the sense in which we use these words; that is, 
they do not, so far as we know, give rise directly to any infectious dis- 
ease. Indirectly they are concerned in the extension of the epidemic 
‘¢ filth diseases,” such as cholera and yellow fever, and of the fatal en- 
demic ‘‘ filth diseases,” such as typhoid fever and diphtheria, which in 
the long run claim more victims than do the pestilential maladies first 
named. This because persons exposed to the foul emanations from sew- 
ers, privy vaults, and other receptacles of filth, have their vital resisting 
power lowered by the continued respiration of an atmosphere contam- 
inated with these poisonous gases, and are liable to become the victims 
of any infectious disease to which they may be exposed. Moreover, the 
accumulations of filth which give off these offensive gases furnish pabu- 


1The Medical News, April 18, p. 425. 


DISINFECTION. 103 


lum upon which certain disease germs thrive; and it may happen that 
the bad smelling air carries something worse than the poisonous gas 
which makes its presence known by offending the sense of smell. It 
may waft to our nostrils infectious particles which are beyond recogni- 
tion by any sense, unless it be the sense of sight with the aid of a good 
microscope. 

We desire, moreover, to have it fully understood that in restricting 
the meaning of the term disinfection within the limits given by the defi- 
nition of the Committee on Disinfectants of the American Public Health 
Association, we do not wish to limit the practice of ‘‘ disinfection,” in 
the popular sense of the word. 

It is but fair to say, also, that this popular usage is supported by good 
authority, and until quite recently has been the common acceptation of 
the term among physicians and chemists. Indeed, it is but a short time 
since the nose test was the only test of ‘‘ disinfection” recognized by 
many intelligent persons. 

Littré, in his Dictionary of the French Language, defines disinfectants 
as ‘‘ substances which destroy, chemically, bad odors.” 

Vallin, the author of the best modern treatise upon ‘‘ Disinfection and 
Disinfectants,” says,— 

‘‘From a scientific point of view there is perhaps an impropriety in 
introducing into the idea of disinfection the suppression of odors which 
offend the sense of smell. The bad odor is not injurious in itself; it is 
an epiphenomenon, which does not necessarily give the measure of the 
hurtful properties of the air, or of any substance whatever. The public, 
unacquainted with medicine, has an unfortunate tendency to judge of 
insalubrity by the bad odor: the absence of this gives to it a deceitful 
security: when they are masked by any device, it [the public] believes 
that all danger has been removed. JVevertheless it ts necessary to 
avoid violating the ordinary sense of words.’ An atmosphere which 
does not in the least offend the sense of smell may certainly be insalubri- 
ous, and engender the gravest maladies; but the fetid or disagreeable 
odors may reveal the presence of injurious principles, of toxic gases, or 
of organic matter in decomposition. We should not too much diminish 
the importance of these offensive odors in the eyes of the public: every- 
thing which smells badly is to be suspected.” ? 

We agree with Prof. Vallin, that the bad odors should arouse suspi- 
cion, and lead to the use of deodorants, or of antiseptics, or of disinfect- 
ants, if required; but let us not leave the public to suppose that when the 
bad odors have been neutralized, the offensive material has been disinfect- 
ed. Letus rather instruct the public that to deodorize and to disinfect 
are not one and the same thing, and that deodorant and disinfectant are 
not synonymous terms. For our part we prefer to ‘‘ violate the ordi- 
nary sense” of the word, and to restrict its signification within such limits 


1 Italics by present writer. 
* Op. Cit, p: 2. 


lien. 


104 DISINFECTION. 


as will prevent confusion, and, what is far worse, a reliance upon ineffi- 
cient methods for the destruction of infectious material. 

In the present essay we shall use the words disinfection and disinfect- 
ant, in accordance with the definition of the committee on disinfectants 
already given. But, inasmuch as this is intended to be a practical treatise 
for popular use, we shall also give, in the proper place, directions for the 
use of deodorants and of antiseptics, so that ‘‘ disinfection,” in the broad 
sense in which the word is commonly used, may be fully considered. 

Tests of Distnfection. What means have we of proving that the 
infective power of infectious material has been destroyed? 

Evidence of disinfection may be obtained (a) from the practical exper- 
iments—experience—of those engaged in sanitary work; (b) by inocu- 
lation experiments upon susceptible animals; (c) by experiments made 
directly upon known disease germs. 

(a) It is a matter of common experience, that when a room has been. 
occupied by a patient with an infectious disease, such as small-pox, scar- 
let fever, or diphtheria, susceptible persons are liable to contract the dis- 
ease weeks or even months after the patient has been removed from it, 
unless in the mean time it has been disinfected. If a second case does 
occur from exposure in such a room, it is evident that it has not been 
disinfected. But the non-occurrence of subsequent cases cannot always 
be taken as evidence that the means of disinfection resorted to were 
efficient. Negative evidence should be received with great caution. In 
the first place, the question as to whether susceptible individuals have 
been fairly exposed in the disinfected room must be considered. Then it 
must be remembered that susceptible persons do not always contract a 
disease, even when they are exposed in a locality known to be infected. 
A further difficulty in estimating the value of evidence obtained in prac- 
tice arises from the fact, that, in connection with the special means of 
disinfection resorted to, such as fumigation, hanging up cloths saturated 
with a disinfecting solution, etc., it is customary to resort to additional 
precautionary measures, such as washing surfaces with soap and hot 
water, white-washing plastered walls, and free ventilation. It is appar- 
ent that under these circumstances it would be unsafe to accept the fact, 
that no other cases occurred in a room treated in this way, as evidence 
that the particular disinfectant used is efficient for the destruction of the 
infectious agent of the disease in question. The fond mother who at- 
taches a charm to her child’s neck to protect it from evil, also takes the 
precaution of guarding it from contact with other children who are sick 
with any infectious disease. If her child fortunately grows to manhood 
or womanhood without having suffered an attack of scarlet fever or diph- 
theria, she may imagine that her charm has protected it, but the evidence 
upon which her faith is founded is not of a nature to convince those 
who are familiar with scientific methods of demonstration. ‘* Well edu- 
cated” persons are often ready to testify in favor of methods of disinfec- 
tion, or of treatment, upon evidence which, from a scientific point of 
view, has no more value than that which the fond mother in question has 


DISINFECTION. IO5 


to offer in favor of the little bag containing camphor or assafcetida, or 
- some other charm of equal value, which she has attached to her child’s 
neck to keep it from catching scarlet fever or diphtheria at school. On 
a par with these charms, so far as disinfection is concerned, we may 
place the saucer of chloride of lime, which it was formerly the fashion to 
place under the bed of a patient sick with an infectious disease, the rag 
saturated with carbolic acid, or chloride of zinc, suspended in the sick- 
room, and even the fumigations with burning sulphur, as sometimes 
practised by those who are unfamiliar with the evidence as to the exact 
value of this agent, and the conditions necessary to ensure successful dis- 
infection with it. 

Chloride of lime, sulphurous acid gas, and carbolic acid are among our 
most useful disinfecting agents, but disease germs are not to be charmed 
away by them any more than by a little bag of camphor. 

Having pointed out the fact that negative evidence, in a restricted field 
of observation, must be accepted with great caution in estimating the 
value of disinfectants, we hasten to say that the combined experience of 
sanitarians, derived from practical efforts to restrict the extension of in- 
fectious diseases, is of the greatest value, and that this experience is to a 
great extent in accord with the results of exact experiments made in the 
laboratory. 

(b) Inoculation experiments upon susceptible animals, made directly 
with infectious material which has been subjected to the action of a disin- 
fectant, have been made by numerous observers. The proof of disinfec- 
tion in this case is failure to produce the characteristic symptoms which 
result from inoculation with similar material not disinfected. Thus, 
Davaine found that the blood of an animal just dead from the disease 
known by English writers as anthrax or splenic fever (Fr. Chardon), 
inoculated into a healthy rabbit or Guinea-pig, in the smallest quantity, 
infallibly produces death within two or three days; and the blood of 
these animals will again infect and cause the death of others, and so on 
indefinitely. This anthrax blood therefore was infectious material, which 
could be utilized for experiments relating to the comparative value of 
disinfectants. Davaine made many such experiments, not only with the 
blood of anthrax, but also with that of a fatal form of septicemia in rab- 
bits, which is known by his name. Other investigators have followed 
up these experiments upon infectious material of the same kind, and also 
upon material from other sources—e. o., the infectious material of glan- 
ders, of tuberculosis, of symptomatic anthrax, of fowl cholera, of swine 
plague, etc. 

It has been proved that the infectious agent in all of the diseases men- 
tioned is a living germ, and that disinfection consists in destroying the 
vitality of this germ. But in experiments made with blood or other 
material obtained directly from diseased animals, the results would be 
just as definite and satisfactory if we were still ignorant as to the exact 
nature of the infecting agent. The test shows the destruction of infect- 
ing power without any reference to the cause of the special virulence, 


106 DISINFECTION. 


which is demonstrated to be neutralized by certain chemical agents in a 
given amount. All of the experiments made with the above mentioned 
kinds of virus have been made upon the lower animals; but there is one 
kind of material which it is justifiable to use upon man himself, and with 
which numerous experiments of a very satisfactory character have been 
made. This material is vaccine virus. Fresh vaccine, when inoculated 
into the arm of an unvaccinated person, gives rise to a very characteristic 
result,—the vaccine vescicle. The inference seems justified that any 
agent which will neutralize the specific infecting power of this material 
will also neutralize the small-pox virus. Thus far it has not been defi- 
nitely proved that the infective agent in vaccine virus is a living germ; 
but the numerous experiments made have shown that the chemical agents, 
which have the power of destroying the various kinds of infectious mate- 
rial heretofore mentioned, have also the power, in about the same 
amounts, of neutralizing vaccine virus, as shown by its failure to pro- 
duce any result when inoculated into an unvaccinated person. In these 
experiments the more careful investigators have taken the precaution of 
vaccinating the same person with disinfected and with non-disinfected 
virus from the same source. A successful vaccination with the non-dis- 
infected virus shows that the individual is susceptible, and the material 
good: failure to produce any result is evidence that the potency of the 
disinfected virus has been destroyed by the chemical agent to which it 
was exposed. 

(c) As already stated, it has been demonstrated that the infectious 
diseases of the lower animals, which have furnished the material for ex- 
periments upon disinfectants by the method of inoculation, are ‘* germ 
diseases,”’ and that the infectious agent is in each case a living micro- 
organism, belonging to the class known under the general name of Bac- 
terta. The bacteria are vegetable organisms, which, by reason of their 
minute size and simple organization, must be placed at the very foot of 
the scale of living things. But they make up in number and in rapidity 
of development for their minute size ; and there is good reason for beliey- 
ing that the infectious diseases of man are also caused by pathogenic— 
disease-producing—organisms of the same class. Indeed, this has already 
been proved for some of these diseases, and the evidence as regards sey- 
eral others is so convincing as to leave very little room for doubt. 

Many of these disease germs are now known to us, not only by mi- 
croscopic examination of the blood and tissues of infected animals, but 
also by ‘‘ culture experiments.” That is, we are able to cultivate them 
artificially in suitable media, and to study their mode of development, 
etc., in the laboratory, quite independently of the animals from which 
our ‘‘ pure cultures” were obtained in the first instance. The culture 
fluids used are prepared from the flesh of various animals; and when to 
one of these a certain quantity of gelatine is added, we have a ‘solid 
culture medium,” upon the surface of which some of these germs will 
grow most luxuriantly. To start such a ‘‘ culture,” it is only necessary 
to transfer, with proper precautions, a minute quantity of the infectious 


DISINFECTION. 107 


material to the surface of our culture medium, or into a fluid which has 
been found to be suitable for the growth of the particular organism which 
we desire to cultivate. A second culture is in the same way started from 
the first, and so on indefinitely. 

Now it is evident that these ‘‘ pure cultures” furnish us a ready means 
for testing the power of various chemical agents to destroy the vitality of 
known disease germs, as shown by their failure to grow in a suitable 
culture medium after exposure for a given time to a given percentage of 
the disinfectant. Very many experiments of this nature have been made 
during the past three or four years. The reader who desires fuller 
details as to the method of conducting such experiments, and of the 
results obtained, is referred to the preliminary reports of the committee 
on disinfectants, of the American Public Health Association, published 
during the current year (1885) in the M/edical News, Philadelphia, and 
which will, doubtless, also be published in full in the next annual volume 
of the association. We may say here, that the experimental data on rec- 
ord indicate that those agents which are efficient for the destruction 
of any one of the pathogenic organisms upon which experiments have 
been made, or of harmless species of the same class,—e. 2., the bacteria 
of putrefaction,—are efficient for the destruction of all, zz the absence of 
spores. ‘There is, it is true, within certain limits, a difference in the 
resisting power of different organisms of this class to chemical agents. 
This is not, however, sufficiently marked to prevent the general state- 
ment that a dis¢tnfectant for one ts a disinfectant for all, in the ab- 
sence of spores. 

The last clause of the above statement calls for an explanation, and 
certain details with reference to the mode of reproduction of disease 
germs. All of the bacteria multiply by binary division; that is, one 
individual divides into two, and each member of the pair again into two, 
andsoon. ‘The spherical bacteria, known as mzcrococcz, multiply only 
in this way, but the rod-shaped bacteria, or daczl/z, also form spores. 
These spores correspond with the seeds of higher plants. They are 
highly refractive, oval or spherical bodies, which, under certain circum- 
stances, make their appearance in the interior of the rods, which cease to 
multiply by binary division when spore formation has taken place. The 
point of special interest with reference to these spores is, that they have 
a resisting power to heat, and to the action of chemical disinfectants, far 
beyond that which is possessed by micrococci, or by bacilli without 
spores. The difference may be compared to the difference between a 
tender plant and its seeds to deleterious influences, such as extremes of 
heat and cold. Thus the spores of certain species of bacilli withstand a 
boiling temperature for several hours, while a temperature of 150° Fahr. 
quickly kills most bacteria in the absence of spores. A similar differ- 
ence is shown as regards the action of chemical agents. Certain agents,— 
é. g., sulphurous acid gas and carbolic acid,—which are extensively used 
as disinfectants, have been proved by exact experiments to be quite im- 
potent for the destruction of spores. This being the case, it is advisable, 


<n 
—_— 


108 DISINFECTION. 


in practical disinfection, always to use an agent which has the power of 
destroying spores, in those cases in which the exact nature of the disease 
germ has not been demonstrated. The cholera germ of Koch does not 
form spores; and there is good reason to believe that the same is true as 
regards the germs of yellow fever, of scarlet fever, and of small-pox, 
which have not yet been demonstrated. This inference is based upon 


evidence obtained in the practical use of disinfectants, and upon certain - 


facts relating to the propagation of these diseases. 

A second general statement, which is justified by the experimental evi- 
dence on record, is, that agents which kill bacteria in a certain amount, 
prevent their multiplication in culture fluids, when present in quan- 


tities considerably less than are required to completely destroy vitality. 


An agent, therefore, which, in a certain proportion and in a given 
time, acts as a ‘* germicide” in a smaller quantity, may act as an azfz- 
septic, z. €., may prevent putrefactive decomposition by restraining the 
development of the bacteria of putrefaction. Antiseptics also prevent or 
retard the development of pathogenic bacteria. It follows from this that 
germicides are also antiseptics; but the reverse of this proposition is not 
true as a general statement, for all antiseptics are not germicides. ‘Thus 
alcohol, common salt, sulphate of iron, and many other substances which 
are extensively used as antiseptics, have scarcely any germicide power, 
even in concentrated solutions, and consequently would be entirely unre- 
liable as disinfectants. 

Practically, antiseptics may accomplish the same result in the long run 
as we obtain in a short time by the use of disinfectants. If, for example, 
we prevent the development of the germs of cholera, or of typhoid fever, 
in an infected privy vault, by the continued use of antiseptics, these germs 
will in time lose their ability to grow, when introduced into a suitable 
culture medium. But in the meantime there is always the possibility 
that some of them may escape, with the fluid contents of the vault, into 
the surrounding soil, and contaminate some well or stream from which 
drinking-water is obtained. For this reason privy vaults, cesspools, and 
sewers should never be allowed to become infected. All infectious ma- 
terial, such as the dejections of patients with cholera or typhoid fever, 
should be destroyed at its source, in the sick-room; or, if it is ascertained 
that such material has been thrown into a privy vault, the entire contents 
of the vault should be promptly disinfected. ‘The same rule applies to 
infectious material thrown upon the ground, or wherever it may be. 

Finally, we desire to emphasize the following propositions : 

Disinfection consists in extinguishing the spark, killing the germ, 
which may light up an epidemic in the presence of a supply of combus- 
tible material—filth. 

The object of gexeral sanitary police is to remove this combustible 
material out of the way, so that no harm may result even if the spark be 
introduced. 

Antiseptics and deodorants are useful when it is impracticable to 
remove offensive organic material from the vicinity of human habitations, 
but they are a poor substitute for cleanliness. 


oe a] 


— 


4 
DISINFECTION. 109 


Psi het tt ts 
DISINFECTION. 


It will be our aim in the present chapter to give reliable, practical di- 
rections with reference to the use of disinfectants, and the best methods 
of disinfection. Keeping this object in view, we shall recommend for 
disinfecting purposes only those agents named in the following list: 


Group I. 


Disinfectants which have the power of destroying spores: 
rere ire. 

2. Steam under pressure (25 lbs.). 

. Boiling water. 

. Chloride of lime (in solution). 

. Liquor soda chlorinate. 

. Mercuric chloride (in solution). 


An pw 


Group 2. 


Disinfectants which are effective in the absence of spores: 
4. Dry heat (230° Fahr. for two hours). 

8. Sulphur dioxide. 

g. Carbolic acid. 

10. Sulphate of copper (in solution) 

11. Chloride of zinc (in solution). 


Note. In the present state of knowledge, a division of disinfecting agents into two groups be- 
comes necessary, unless we would entirely dispense with the use of those agents named in our sec- 
ond group, which cannot be relied upon for the destruction of spores, and consequently cannot be 
recommended for the destruction of all kinds of infectious material. As this group includes several 
agents which are extensively used for disinfecting purposes, and which we believe to possess great 
practical value, we have considered it necessary to make this distinction. The present state of 
science, however, does not enable us to classify all infectious diseases in the same way, and ‘in case 
of doubt it will always be advisable to use those agents included in Group 1. But in the absence of 
a precise knowledge of the nature of the germ, we may in certain cases be governed by the practical 
experience of sanitarians, and by experiments which have been made directly upon infectious ma- 
terial, ¢. ¢., on vaccine virus. In our recommendations we have taken account of this kind of evi- 
dence, as well as of laboratory experiments, in which known disease germs or harmless organisms of 
the same class have served as the test of disinfecting power. 


We shall first give a brief account of the conditions of successful disin- 
fection with these agents, as established by experimental data, and after- 
ward detailed directions for their employment under the various circum- 
stances in which disinfection is required. 

I. Fire. It is hardly necessary to say that burning of infectious ma- 
terial, infected clothing, etc., is an effectual method of disposing of it. 
This method of disinfection is always to be recommended, when practi- 
cable or consistent with a due regard for economy and the rights of 
individuals. As a rule, articles of little value, which have been soiled 
with infectious material, had better be burned ; and this is especially true 
of old clothing and bedding. But we have other efficient methods of 


IIo DISINFECTION. 


disinfection, which make it unnecessary to sacrifice articles of value except 
under unusual circumstances. 

2. Steam under Pressure. The disinfecting power of steam given off 
from boiling water in an open vessel does not differ from that of the 
water itself, but confined steam has a temperature corresponding with 
the pressure as indicated by a steam gauge. At twenty pounds pressure 
the temperature is about 230° Fahr. (105° C.) ; at twenty-five pounds it 
is about 240° Fahr. ; at thirty pounds it is 250° Fahr. Moist heat at the 
lowest temperature named destroys the most resistant spores in twenty 
minutes, while a temperature of 240° Fahr. is effective almost immedi- 
ately.? | 

3. Boiling. In the absence of spores, bacteria are quickly killed ata 
temperature considerably below the boiling point of water, and it is safe 
to say that boiling for half an hour will destroy all known disease germs, 
including the spores of anthrax, which have less resisting power than the 
spores of certain harmless and widely distributed bacilli, which have 
been found to resist boiling for several hours. 

g. Chloride of Lime (chlorinated lime, bleaching powder). ‘This is 
one of the cheapest and most efficient of disinfectants. It should be 
packed in air-tight and moisture-proof receptacles,—glass is preferable,— 
and should contain at least 25 per cent. of available chlorine.? It should 
be used in solution, which had better be made as required. An insoluble 
residue will be left, which may be removed by filtration or decantation. 
This, however, is not at all necessary. Chlorinated lime owes its disin- 
fecting power to the presence of the hypo-chlorite of lime, a salt which 
is freely soluble in water, and which is quickly decomposed by contact 
with organic matter. Germs of all kinds, including the most resistant 
spores, are destroyed by this solution, but it must be remembered that 
the disinfectant itself is quickly decomposed and destroyed by contact 
with organic matter, and that if this is present in excess, disinfection 
may not be accomplished, especially when the germs are embedded in 
masses of material which are left after the hypo-chlorite of lime has all 
been exhausted in the solution. 

5. Liguor Sode Chlorinate (Labarraque’s solution). This is a solu- 
tion of the hypo-chlorite of soda. Its value as a disinfectant corresponds 
with that of solutions of the hypo-chlorite of lime of the same strength. 
The preparations in the market vary greatly in value, and some of those 
tested by the committee on disinfectants® were found to be practically 
without value. This is due to the fact that the solution does not keep 
well. For this reason, and on the score of economy, a solution of chlo- 
ride of lime will be preferable for most purposes. Labarraque’s solution 
is, however, a more pleasant preparation for bathing the surface of the 
body, and both as a deodorant and a disinfectant will be found useful in 


1 See Preliminary Report of Committee on Disinfectants, in The Medical News, Philadelphia, 
March 14, 1885, p. 284. 

2 The test for available chlorine is given in Preliminary Report No. 11 of the Committee on Dis- 
infectants, l. c., Jan. 7, p. 148. 


BT C.g DD Y-O 50, 


, 


DISINFECTION. IIt 


the sick-room. It should contain at least 3 per cent. of available chlo- 
rine. 

6. Mercuric Chloride (bichloride of mercury, corrosive sublimate). 
This salt is well known as a deadly poison, which has long been used in 
domestic practice as a ‘“‘bug poison.” Recent researches show that .t 
has germicide powers of the first order, and it is consequently a disinfect- 
ant which may be recommended for certain purposes, due regard being 
had to its poisonous nature, and to the fact that it is decomposed by con- 
tact with lead, tin, or copper, and that lead pipes are soon rendered brit- 
tle and worthless by passing through them solutions of mercuric chloride. 
Its potency in dilute solutions (1 : 500 to 1: 4000) makes it compara- 
tively cheap,’ and the danger of accidental poisoning from such dilute 
solutions is not very great. The concentrated solutions should be col- 
ored, as a precaution against accident, for they have neither color nor 
odor to reveal their deadly nature. 

A standard solution which contains four ounces to the gallon of water 
is of convenient strength for a concentrated solution, to be issued by man- 
ufacturers or health authorities, in properly labelled bottles. This may 
be colored with permanganate of potash,? or with indigo, or with aniline 
blue. Inasmuch as standard solution No. 2 of the committee on disin- 
fectants is colored with the permanganate, it would perhaps be better 
to give this solution a blue color. The writer would suggest the follow- 
ing formula, in which another poisonous metallic salt contained in our 
list is combined with the mercuric chloride: 


Mummies mercury,» . - 9). se ee uy 4 OUNCES. 
MEE CON PCL, 6 ee ee ® E pound. 
Cw wy ae E gallon. 


It must be remembered, in using this and other disinfecting solutions, 
that the condition relating to time of exposure to the action of the disin- 
fecting agent is an important one. The experimental evidence® relating 
to the germicide power of mercuric chloride shows that the time of 
exposure being two hours, this salt may be safely recommended for the 
destruction of spore-containing infectious material in the proportion of 
I: 1000, and of pathogenic organisms in the absence of spores in the 
proportion of 1 : 4000, or even less, provided that the micro-organisms 
tobe destroyed are fairly exposed to tts action. ‘The fact that mercuric 
chloride combines with and coagulates albuminous material, interferes 
to some extent with its value as a disinfectant, and will be kept in view 
in the recommendations to be made hereafter relating to the practical 
use of this agent. Mercuric chloride is an efficient antiseptic in the pro- 
portion of 1 : 15,000, and it exercises a restraining influence upon the 
development of the spores of the anthrax bacillus, when present in cul- 
ture solutions, in the proportion of 1 : 300,000, and even less. 


1 It costs about fifty cents a pound by the quantity. 
2 Ten grains to the gallon is sufficient. 
3 The Medical News, Feb. 21, p. 205. 


II2 DISINFECTION. 


7. Dry FHleat. Dry heat is only to be recommended for the disinfec- 


tion of such articles as would be injured by exposure to moist heat, or to 
a oN een solution. A properly constructed disinfection chamber 
or ‘‘ oven” is absolutely essential, if dry heat is to be used. The experi- 
mental evidence on record! shows that the destruction of spores requires 
a temperature which would injure woollen fabrics (140° C. for three 
hours). In the absence of spores, however, articles which are freely ex- 
posed for two hours to a temperature of 110° C. (230° Fahr.) may with 
safety be considered disinfected. In practice it will be necessary to 
remember that the penetrating power of dry heat is very slight, and that 
packages, bundles, or even articles loosely thrown one upon another, can- 
not be disinfected in this way. 

&. Sulphur Dioxide (sulphurous acid gas). Fumigation with burning 
sulphur has long been a favorite method of disinfection. The experience 
of sanitarians is in favor of its use in yellow fever, small-pox, scarlet 
fever, diphtheria, and other diseases in which there is reason to believe 
that the infectious material does not contain spores. The experimental 
evidence on record? shows that under certain conditions it is effective for 
the destruction of micro-organisms in the absence of spores, but that it is 
quite impotent for the destruction of these reproductive elements. 

The presence of moisture adds greatly to the disinfecting power of this 
agent. It is freely soluble in water, one volume dissolving fifty volumes 
of the gas. It is therefore evident that a saturated aqueous solution is 
fifty times as strong as the pure gas—anhydrous. In aqueous solution, 
in the proportion of 1 : 2000 by weight, sulphur dioxide kills micrococci 
in two hours’ time. Ina gas-tight receptacle it destroys the infecting 
power of vaccine virus dried upon ivory points, when present in the pro- 
portion of one volume per cent., the time of exposure being six hours. 
The same proportion destroys anthrax bacilli, without spores, from the 
spleen of an animal recently dead, dried upon silk threads, in thirty min- 


utes (Koch). These facts show that sulphur dioxide is a valuable dis- 
infectant ; but the conditions of successful disinfection, as established by 


the experimental evidence, are, that the material to be disinfected shall be 
freely exposed to its action for a considerable time, zz a receptacle which 
does not permit the gas to escape. It must be remembered that disin- 
fection of a thin layer of vaccine virus upon an ivory point, or of anthrax 
blood upon a silk thread, exposed in a gas-tight receptacle, cannot be 
taken as evidence that thicker layers of infectious material, attached to 
the surface of bedding and clothing, or enclosed in folded blankets, bun- 
dles of clothing, matresses, etc., can be disinfected by the same amount 
of sulphur dioxide generated in a room which is not gas-tight. It has 
been shown, by carefully conducted experiments,® that the escape of 


1See Medical News, March 14, p. 283. 
*See Prelim. Rep., No. VII, The Med. News, March 28, p. 343. 


$l.c., p. 348. 
41. ¢., D. 344. 
51. c., p. 347. 


DISINFECTION. II3 


sulphurous acid gas from a bed-chamber or hospital ward is very rapid, 
in spite of the usual precautions for stopping up crevices when such a 
room is to be fumigated ; and infectious material, enclosed in bundles or 
protected by folds of blankets, etc., may escape disinfection, after having 
been exposed for many hours in a tightly closed chamber containing ten 
yolumes per cent. of this gas. 

g. Carbolic Acid. The disinfecting power of carbolic acid has been 
fixed by experiments upon vaccine virus, and upon various pathogenic 
organisms. A saturated aqueous solution cannot, however, be relied 
upon for the destruction of spores ; but*in the absence of spores it is fatal 
to micro-organisms in the proportion of two per cent., the time of expos- 
ure being two hours. Indeed, less than one per cent. is fatal to several 
of the species of pathogenic micrococci which have served as test-organ- 
isms in the numerous experiments which have been made with this agent.? 
Upon the recommendation of the famous Dr. Koch, the discoverer of the 
cholera bacillus, the committee on disinfectants, of the International San- 
itary Conference of Rome (1885), has given this agent the first place for 
disinfecting soiled clothing, excreta, etc., in cholera. For excreta it is 
to be used in five per cent. solution, and for clothing, etc., in two per 
cent. solution. ‘The experimental evidence upon record indicates that it 
may be relied upon in this proportion. 

ro. Sulphate of Copper. This salt has been largely used as a disin- 
fectant in France, and recent experiments show that in the proportion of 
one per cent. it is a reliable agent for the destruction of micro-organisms, 
in the absence of spores. It is much below mercuric chloride in germi- 
cide power, but is a better deodorant—not a better antiseptic—than the 
more poisonous salt. When we take into account its efficiency, it is com- 
paratively cheap, and is to be recommended for certain purposes. It 
may be combined with the more potent germicide, mercuric chloride, in 
accordance with the formula already given. 

Ir. Chloride of Zinc. Solutions of chloride of zinc are largely used 
in this country and in Europe for disinfecting purposes. It is an excel- 
lent antiseptic and deodorant, but its power to destroy disease germs has 
been very much over-estimated. It may, however, be relied upon for the 
destruction of pathogenic organisms, in the absence of spores, in solu- 
tions which contain from five to ten per cent. of the salt. 


GENERAL DIRECTIONS FOR DISINFECTION. 


** In the sick-room we have disease germs at an advantage, for we know 
where to find them, as well as how to kill them. Having this knowl- 
edge, not to apply it would be criminal negligence, for our efforts to re- 
strict the extension of infectious diseases must depend largely upon the 
proper use of disinfectants in the sick-room.” ? 


1Prelim. Rep. of Com. on Disinfectants, No. VI, 1. c., p. 317. 
2 Prelim. Rep. of Com. on Disinfectants of A. P. H. A. 


a 


IIl4 DISINFECTION. 


Disinfection of Lxcreta, etc. The dejections of patients suffering 
from an infectious disease should be disinfected before they are thrown 
into a water-closet or privy vault. This is especially important in chol- 
era, typhoid fever, yellow fever, and other diseases in which there is evi- 
dence that the infectious agent is capable of self-multiplication, in suita- 
ble pabulum, external to the human body. Vomited matters, and the 
sputa of patients, with these and other infectious diseases, should also be 
promptly disinfected. ‘This is especially important in cholera, diphthe- 
ria, scarlet fever, whooping-cough, and tuberculosis. It seems advis- 
able, also, to treat the urine of patients sick with an infectious disease 
with a disinfecting solution. 

For the disinfection of excreta, etc., in the sick-room, a solution of 
chloride of lime is to be recommended. This is an excellent and prompt 
deodorant, as well as a disinfectant. A quart of the standard solution 
(No. 1), recommended by the committee on disinfectants, of the Amer- 
ican Public Health Association, will suffice for an ordinary liquid dis- 
charge in cholera or typhoid fever ; but for a copious discharge it will be 
prudent to use twice this quantity, and for solid fecal matter a stronger 
solution will be required. As chloride of lime is quite cheap, it will 
be best to keep on the safe side, and to make the solution for the disin- 
fection of excreta by dissolving eight ounces of chloride of lime in a gal- 
lon of water. This solution should be placed in the vessel before it 
receives the discharge. The material to be disinfected should be well 
mixed with the disinfecting solution by agitating the vessel, and from 
thirty minutes to an hour should be allowed for the action of the disin- 
fectant, before the contents are thrown into a water-closet or privy vault. 

Standard Solution No. 2, of the committee on disinfectants, which 
contains two drachms of corrosive sublimate and two drachms of per- 
manganate of potash to the gallon of water, if used freely—one quart for 
each dejection—and left in contact with the material to be disinfected for 
at least four hours, is a reliable disinfectant_for liguid discharges. The 
caution with reference to lead pipes must be remembered, and if this 
solution is used in the sick-room or in hospital wards, it will be desirable 
to have receptacles of wood or earthern ware for the disinfected material, 
which may be carried away and emptied in a suitable locality once in 
twenty-four hours. 

The blue solution heretofore suggested would also be suitable for use 
in the same way, and with the same precautions. It contains four ounces 
of corrosive sublimate and a pound of sulphate of copper to the gallon of 
water. This concentrated solution should be diluted in the proportion 
of eight ounces to the gallon of water, and the diluted solution used as 
heretofore recommended—at least a quart for each dejection, and four 
hours’ time. The disinfecting power of the copper salt adds to the value 
of this solution, and the bright blue color of the concentrated solution 
leaves nothing to be desired in the way of a color protection against acci- 
dental poisoning. 

For the disinfection of the discharges of cholera patients, a five per 


ae 


DISINFECTION. I15 


cent. solution of carbolic acid may be used, in accordance with the rec- 
ommendation of the International Sanitary Conference of Rome. The 
time necessary to insure disinfection is fixed at four hours. 

Chloride of zinc in ten per cent. solution may be used for the dejec- 
tions of cholera patients, the same conditions being observed in regard to 
quantity and time of exposure as were fixed for the other metallic salts 
named. 

It will be best to burn cloths used to wipe away the discharges of the 
sick, and especially those used in wiping away the infectious material 
from the mouth and nostrils of patients with diphtheria or scarlet fever. 
Bits of old muslin may be used for this purpose, and should at once be 
thrown upon an open fire or gas stove arranged in the fire-place for this 
purpose. 

Infected sputum may be discharged directly into a cup nalf full of the 
solution of chloride of lime recommended for excreta, or of Labarraque’s 
solution. 

Handkerchiefs, napkins, and towels used in wiping away infectious 
discharges, if worth preserving, should be at once immersed in one of the 
following solutions: Chloride of lime, 2 per cent.; carbolic acid, 2 per 
cent. ; mercuric chloride, 0.1 per cent. (=I : 1000). 

The blue solution (containing sulphate of copper), diluted in the pro- 
portion of four ounces to the gallon of water, may also be used for this 
purpose. Cloths used for washing the general surface of the body should 
also be disinfected with one of the above mentioned solutions ; and attend- 
ants should invariably disinfect their hands by washing them in one of 
these solutions, when they have been soiled by the discharges of the 
sick. | 
_ Disinfection of the Person. Labarraque’s solution, diluted with 
twenty parts of water, is a suitable disinfecting solution for bathing the 
entire surface of the body of the sick, of convalescents, or of those whose 
duties take them into the sick-room; or a 1 per cent. solution of chloride 
of lime, or a 2 per cent. solution of carbolic acid, may be used. 

The International Sanitary Conference of Rome gives the following 
directions with reference to the disinfection of the body after death from 
cholera : 

** The body should be enveloped in a sheet saturated with one of the 
Strong disinfecting solutions,’ without previous washing, and should at 
once be placed in a coffin.” 

We see no objection to washing the body, if the strong solution of 
chloride of lime is used for this purpose. Washing with water would 
necessitate the careful disinfection of the water and cloths used for this 
purpose, and of the hands of the attendants. As the odor of chlorine or 
of carbolic acid would be objectionable under certain circumstances, we 
see no good reason for insisting upon the use of these agents, rather than 
on the odorless solution of mercuric chloride, which, in the proportion of 
I; 1000, would no doubt be equally effective. But when there is an 


1 Chloride of lime 4 per cent., or carbolic acid 5 per cent. 


116 DISINFECTION. 


odor of decomposition to be neutralized, the solution of chloride of lime 
will have a decided advantage on account of its deodorizing properties. 

Disinfection of Clothing and Bedding. ‘The cheapest and best way 
of disinfecting clothing and bedding, which is not injured by the ordinary 
operations of the laundry, is to immerse it in boiling water for half an 
hour or longer. It should be placed in boiling water as soon as removed 
from the person or the bed of the sick, and if it is necessary to remove 
the articles from the room in order to accomplish this, they should be 
wrapped in a sheet or towel thoroughly saturated with a disinfecting so- 
lution. If it is impracticable to disinfect such infected clothing and bed- 
ding zmmedzately by boiling, it will be necessary to immerse it in one of 
the following disinfecting solutions, in which it should be left for four 
hours: Mercuric chloride, 1 : 2000; or the ‘‘ blue solution” of this salt and 
sulphate of copper, diluted by adding two fluid ounces of the concen- 
trated solution to a gallon of water; or a 2 per cent. solution of carbolic 
acid. The solution of chlorinated lime (2 per cent.) may also be used, 
but we give the precedence to the first mentioned solutions, because of 
the bleaching properties of this solution. The blue solution does not in- 
jure clothing, and is to be preferred for domestic use to a simple solution 
of corrosive sublimate, which in the concentrated form is highly poison- 
ous, and without odor or color. When diluted as directed, this solution 
may, however, be used without danger either from absorption through 
the hands, or by drinking. The metallic taste of the diluted solution 
could scarcely fail to prevent a fatal dose from being swallowed acci- 
dentally. 

For outer clothing, and other articles which would be seriously injured 
by immersion in boiling water, the best disinfectant is steam. Exposure 
to steam at 100° C. (212° Fahr.) for half an hour would be equivalent to 
exposure in boiling water for the same time, if the clothing is hung upin 
such a manner as to be fairly brought under the action of the disinfecting 
agent. To be certain that the steam does not fall below this temperature 
in the disinfection chamber, a thermometer must be placed in a corner of 
the room, at a distance from the point of entrance of the steam, or in an 
aperture from whichthe steam escapes. This should mark atleast 100° C. 
for half an hour before the disinfection can be considered complete. To 
accomplish this, it is evident that the steam must come from the gener- 
ator at a higher temperature, or, in other words, must be under pressure. 

It must be remembered that the destruction of spores is the most diffi- 
cult test of disinfecting power known, and one which excludes the use of 
carbolic acid, sulphur dioxide, and other agents which enjoy the confi- 
dence of sanitarians, and which have been proved by laboratory experi- 
ments to destroy pathogenic organisms in the absence of spores. There 
is good reason for the belief that dry heat and sulphurous acid gas may 
be safely substituted for steam for the disinfection of the clothing of pa- 
tients with cholera, yellow fever, and small-pox, and probably in several 


1 The committee on disinfectants of the International Sanitary Conference of Rome fixes one 
hour as the time during which steam should be made to pass over the articles to be disinfected. 


DISINFECTION. Lo, 


other infectious diseases (puerperal fever, erysipelas, diphtheria (?), and 
scarlet fever (?) ) 

As disinfection by steam will injure certain articles, dry heat may be 
used as a substitute for moist heat, but in this case a temperature of at 
least 110° C. (230° Fahr.), maintained for two hours, will be required. 
In the use of dry heat, even greater care is necessary that the articles to 
be disinfected are freely exposed,—that is, not placed in the oven in bun- 
dies, or piled one upon another, but freely suspended in the disinfecting 
chamber. For it has been shown by carefully conducted experiments 
that the penetrating power of dry heat is very slight. A properly con- 
structed disinfection oven, such as that of Ransom,} will be required if 
dry heat is to be used. 

As the appliances for disinfecting with steam or with dry heat are 
somewhat expensive, these agents are not likely to supplant, for general 
use, the time-honored practice of fumigation with sulphurous acid gas. 
This method of disinfection commends itself because of the cheapness of 
the material used, and the facility of its application. Sulphur dioxide is 
a less reliable disinfectant than steam or dry heat, but when the necessary 
conditions are observed there is no doubt of its utility ; and the fact that 
it does not kill the spores of anthrax and of other bacilli is no reason for 
rejecting an agent which has been demonstrated by experience to be one 
of great value, which has been proved by laboratory experiments to be 
fatal to pathogenic organisms in the absence of spores, and to destroy the 
infecting power of vaccine virus. But in using this agent the conditions 
of successful disinfection, which have been established by experiment, , 
should be borne in mind. The room which is to serve as a disinfecting 
chamber must be very thoroughly closed: every crevice and key-hole 
should be carefully stopped with cotton, or by fastening paper over it. 
Even this precaution will not prevent the rapid escape of gas from cracks 
around doors, windows, etc. It is therefore desirable, when practicable, 
to use a disinfecting chamber which can be hermetically closed. The 
articles to be disinfected must be very freely exposed, and should never 
be thrown into the room in bundles, or piled one upon another. We 
concur in the recommendations of the committee on disinfectants of the 
American Public Health Association, as to the amount of sulphur which 
should be burned, and the method of effecting its complete combustion : 


““To secure any result of value, it will be necessary to close the apart- 
ment to be disinfected as completely as possible, by stopping all apertures 
through which gas might escape, and to burn at least three pounds ot 
sulphur for each thousand cubic feet of air-space in the room. To secure 
complete combustion of the sulphur, it should be placed, in powder or in 
small fragments, in a shallow iron pan, which should be set upon a 
couple of bricks in a tub partly filled with water, to guard against fire. 
The sulphur should be thoroughly moistened with alcohol before igniting 
Hee 

1 British Medical Fournal, Sept. 6, 1873, p. 274. 
2 Preliminary Report, l. c., p. 427. 


a 
‘ 
= Rt 


118 DISINFECTION. 


Finally, we would remark, that in the absence of suitable appliances 
for disinfection, and in general when the infected articles are of little 
value, consumption by fire furnishes the readiest and safest method of 
disposing of such articles. : 

For articles of value, such as upholstered furniture, etc., which would 
be injured by any of the processes heretofore recommended, free exposure 


to the air (aeration) for three or four weeks is directed by the committee 


on disinfectants of the International Sanitary Conference of Rome. The 


same committee directs that ‘‘ objects made of leather, such as trunks, 


boots, etc., should be destroyed, or washed several times with one of the 


weak disinfection solutions,”—carbolic acid 2 per cent., or chloride of 
lime 1 per cent. 

The means heretofore recommended for the disinfection of woollen 
clothing, blankets, and similar articles. will not be sufficient for soiled 
mattresses. As a rule, they should be opened, and the contents disin- 
fected by steam or by dry heat, with subsequent free aeration, and the 
cover should be washed in boiling water after treatment with a disinfect- 
ing solution. 

Disinfection of the Sick-Room. Every effort should be made to 
prevent a room occupied by patients sick with an infectious disease from 
becoming infected. Carpets, stuffed furniture, curtains, and other arti- 
cles difficult to disinfect, should be removed at the outset. Indeed, noth- 
ing should be left in the room which is not absolutely required, and all 
furniture and utensils should be of such a character that they can be 
readily disinfected by washing with boiling water or with a disinfecting 
solution. Abundant ventilation and scrupulous cleanliness should be 
maintained, and a disinfecting solution should always be at hand for 
washing the floor, or articles in use, the moment they are soiled by infec- 
tious discharges. For this purpose a solution of chloride of lime may be 
used (4 per cent.). 


It is impracticable to destroy infectious material in an occupzed apart- — 


ment by means of gases or volatile disinfectants, for to be effective these 
must be used in a degree of concentration which would make the atmos- 
phere of a room quite irrespirable. These agents are therefore useful 
only as deodorants. They are all more or less offensive to the sick, and 
will seldom be required, even as deodorants, when proper attention is 
paid to cleanliness and ventilation. 

Daily wiping of all surfaces—floors, walls, and furniture—with a cloth 
wet with a disinfecting solution, is to be recommended. For this pur- 
pose a solution of chloride of lime (2 per cent.), or of carbolic acid (2 
per cent.), or of mercuric chloride (1 : 2000), may be used. 

By such precautions as have been indicated, the infection of the sick- 
room may be prevented, especially in those diseases, such as cholera and 
typhoid fever, in which the infectious agent is not given off in the breath, 
or from the general surface of the body, of the sick person. In small- 
pox and in scarlet fever there is greater danger that the infectious agent 
may remain attached to surfaces in the room; for the atmosphere be- 


DISINFECTION. II9g 


comes infected with particles given off from the surface of the patient’s 
body. 

As already stated, the atmosphere cannot be disinfected while the room 
is occupied. ‘There is much less reason for disinfecting it when the pa- 
tient has been removed, and it is much simpler to renew it by throwing 
open the doors and windows than to attempt to disinfect it. Indeed, 
there will be no infectious particles to destroy, except such as are dis- 
lodged from surfaces, window ledges, etc., where they have settled as 
dust while the room was occupied; and if the precautions above recom- 
mended have been taken, the danger of such reinfection of the atmos- 
phere will be reduced to a minimum. 

Disinfection of the vacated room, then, consists in the destruction of 
all infectious particles which remain attached to surfaces, or lodged in 
crevices, in interstices of textile fabrics, etc. The object in view may 
be accomplished by thorough washing with one of the disinfecting solu- 
tions heretofore recommended; but most sanitarians think it advisable, 
first, to fumigate the room with sulphur dioxide. ‘This practice is to be 
recommended, and the directions given by the committee on disinfectants, 
already quoted, should be followed (3 lbs. of sulphur to 1,000 cubic feet 
of air space). At the end of from twelve to twenty-four hours, doors and 
windows should be opened, and the room freely ventilated. After this 
fumigation, all surfaces should be washed with a disinfecting solution 
(chloride of lime 2 per cent., carbolic acid 2 per cent., or mercuric 
chloride 1 : 1000), and afterwards thoroughly scrubbed with soap and hot 
water. Plastered walls should be white-washed. The fumigation rec- 
ommended is especially important in the case of rooms, the walls of 
which are covered with paper, and in rooms from which curtains, car- 
pets, etc., have not been removed; and under these circumstances it 
will, as a rule, be advisable to repeat the fumigation a second or even a 
third time. The process is inexpensive, and the old saying that ‘+ What- 


ever is worth doing at all is worth doing well,” applies with especial 


force to the use of disinfectants. Excessive precaution can do no harm, 
but the inefficient use of disinfecting agents, which results from indiffer- 
ence, or from ignorance of the precise value of the agents relied upon, 
may be disastrous. 

Disinfection of Privy Vaults, Cesspools, etc. ‘The contents of privy 
vaults and cesspools should never be allowed to accumulate unduly, or to 
become offensive. By frequent removal, and by the liberal use of anti- 
septics, such necessary receptacles of filth should be kept in a sanitary 


‘condition. The absorbent deodorants, such as dry earth, or pounded 


charcoal,—or the chemical deodorants and antiseptics, such as chloride of 
zinc, sulphate of iron, etc.,—will, under ordinary circumstances, prevent 
such places from becoming offensive. Disinfection will only be required 
when it is known, or suspected, that infectious material, such as the de- 
jections of patients with cholera, yellow fever, or typhoid fever, has been 
thrown into the receptacles, which are especially dangerous, because they 
already contain pabulum suitable for the development of the germs of 


4 


120 DISINFECTION. 


these diseases. Mercuric chloride commends itself especially for the 
disinfection of such masses of material, because, even if any germs 
escape immediate destruction, they will fail to multiply in the presence 
of this potent antiseptic. The chloride of lime solution, on the contrary, 
is preferable for use in the sick-room, because of the promptness and 
certainty of its germicide action and its deodorizing power. But it has 
the disadvantage, where large masses of material are to be disinfected, 
that it is itself destroyed by contact with organic matter; and that if 
there is a surplus of infectious material after the disinfecting solution has 
been neutralized, this will be as potent for mischief as a larger quantity 
would have been. 

Mercuric chloride should be used zz solution, in the proportion of 
‘¢one pound for every five hundred pounds—estimated—of fecal matter 
contained in the vault.’ All exposed portions of the vault, and the 
wood-work above it, should be thoroughly washed down with the disin- 
fecting solution.” ? 

The subsequent daily use of a smaller quantity of the same solution 
would ensure the continued disinfection of fresh material thrown into the 
vault. Or chloride of lime in powder may be freely scattered over the 
contents after the first disinfection with mercuric chloride. A diluted 
powder, made by mixing one pound of chloride of lime with nine pounds 
of plaster of Paris, or of clean, well dried sand, may be used for this pur- 
pose. Thisis more easily spread about, can be used more economically, 
and is sufficiently strong in chlorine for practical purposes. As chloride 
of lime is an excellent deodorant as well as a disinfectant, such a powder 
commends itself for general use in open privy vaults and cesspools, not 
only during the prevalence of epidemics, but at all times when they give 
evidence of being in an unsanitary condition. 

flospitals. ‘The directions already given in regard to disinfection of 
the sick-room and its contents apply as well to hospital wards in which 
patients with infectious diseases are treated. In addition to this, it will 
be necessary in hospitals to guard against such infectious diseases as 
erysipelas, septicemia, puerperal fever, and hospital gangrene. The 
antiseptic treatment of wounds, in connection with a proper regard for 
cleanliness and ventilation, has practically banished these diseases from 
well regulated hospitals. Of the first importance in effecting this are the 
precautions now taken with reference to the disinfection of sponges, in- 
struments, the hands of attendants, etc. 


Instruments of silver, such as probes and catheters, may be disinfected 


by passing them through the flame of an alcohol lamp. Instruments of 
steel, gum catheters, etc., may be disinfected by immersion in a five per 
cent. solution of carbolic acid, or in a 1 : 1000 solution of mercuric chlo- 
ride. For instruments and vessels of copper, brass, and tin, boiling 


1 Recent experiments made by the writer make it apparent that the complete sterilization of large 
masses of fecal matter in privy vaults would be a difficult and expensive undertaking, if not entirely 
impracticable. It is therefore of prime importance that infectious material should be destroyed be- 
fore it is thrown into a receptacle of this kind. 


* Prelim. Rep. of Com. on Disinfectants, 1. c. 


fs 


_ 


DISINFECTION. I2I 


water, or the carbolic acid solution, may be used. Vessels of porcelain 
or glass may be disinfected by heat, or by either of the disinfecting solu- 
tions mentioned. Sponges should be kept permanently in one of the dis- 
infecting solutions, or, what is better, may be dispensed with entirely for 
the cleansing of wounds. In place of them, irrigation with a disinfecting 
solution may be resorted to, or the discharges may be wiped away with. 
some cheap absorbent material which can be burned after having been 
once used. 

Patients in hospitals, with infectious diseases, will of course be kept in 
isolated warts. Everything which comes from such a ward should be 
disinfected, and the immediate attendants of the sick should not be 
allowed to visit other parts of the hospital without first changing their 
outer clothing for a recently disinfected suit, and washing their hands in 
a disinfecting solution. When relieved from duty their underclothing 
should also be disinfected; and they should take a complete bath with 
one of the weak disinfecting solutions heretofore recommended. 

Every hospital should be provided with a steam disinfecting apparatus, 
or with an oven for disinfection by dry heat. 

Disinfection of Water and Articles of Food. The disinfection of 
drinking-water on a large scale, in reservoirs, wells, etc., is impractica- 
ble. But it is a very simple matter to disinfect water which is suspected 
of being contaminated with the germs of cholera, typhoid fever, or any 
other disease transmissible in this way. This is readily accomplished by 
boiling. As already stated, all known disease germs are destroyed by 
the boiling temperature maintained for halfan hour. The importance of 
this precaution during the prevalence of an epidemic of cholera or of 
typhoid fever cannot be over-estimated, when the water used for drinking 
purposes comes from an impure source, or is liable to contamination by 
the discharges of patients suffering from these diseases. Those articles 
of food, and especially milk, animal broths, etc., which might serve as 
pabulum for disease germs, should, during the prevalence of an epidemic, 
be cooked but a short time before they are eaten. And such food, if put 
aside for some hours after it has been prepared, should always be again 
subjected to a boiling temperature shortly before it is served. Food 
which gives evidence of commencing putrefaction is unfit for use, and in 
time of epidemics is especially dangerous. 

Disinfection of Ships. It should be the aim of a physician attached 
to a passenger ship, or of the master of a vessel having no physician on 
board, to prevent the vessel from becoming infected when in an infected 
port, or when cases of infectious disease occur on board. This is to be 
accomplished by keeping the ship clean; by disinfecting suspected arti- 
cles, and especially the soiled clothing of passengers, before they are 
received on board; by the isolation of cases of infectious disease which 
occur on board; and by the thorough execution of those measures of dis- 
infection recommended for the sick-room. When a case of cholera or of 
yellow fever occurs upon a ship at sea, it cannot be taken as evidence 
that the vessel is infected unless at least five days have elapsed since the 


I22 DISINFECTION. 


person attacked came on board. For he may have contracted the disease 
from exposure at the port of departure, or in some other locality on shore. 
When, however, a longer time than this has elapsed, or when several 
cases develop in a particular locality on ship-board, either simultaneously 
or successively, the vessel must be considered infected, unless it is shown 
that the cases are directly due to the opening of baggage containing in- 
fected clothing. 

In practice, the sanitary officials at the port of arrival usually treat a 
vessel as infected if any cases of infectious disease have oceurred upon 
her during the voyage. This is a safe general rule, which should not 
be departed from unless a considerable time—five to seven days—has 
elapsed since the cases occurred, and they can be clearly traced to expos- 
ure before coming on board. In this case, if the ship is clean and the 
precautions relating to disinfection and isolation of the sick have been 
faithfully executed, the health officer may be justified in dispensing with 
the general measures of disinfection which are required for an infected 
ship. 

These measures do not differ from those heretofore recommended for 
the disinfection of the sick-room and its contents; but the special condi- 
tions on ship-board, and the great interests at stake, make it essential 
that the execution of these measures should be in the hands of sanitary 
experts. 

In the disinfection of ships, fumigation with sulphurous acid gas is a 
measure of prime importance, and is largely practised by those in charge 
of quarantine establishments. The fact that the ship may be almost her- 
metically closed, and the escape of gas to a great extent prevented, makes 
this method of disinfection more trustworthy than in the case of dwellings 
and hospitals. The further fact, that certain parts of the ship are inac- 
cessible for the application of disinfecting solutions, seems to make the 
use of a gaseous disinfectant imperative. 

Disinfection by means of steam, especially of an iron vessel, would no 
doubt be a difficult matter on account of the condensation which would 
occur from contact with the cool walls of the vessel below the water-line. 
But it will be well to fill the vessel with steam before introducing the 
sulphur dioxide; for, as already stated, the disinfecting power of this 
agent is much greater in presence of moisture. A well equipped quar- 
antine establishment should have an apparatus for generating sulphurous 
acid gas, and injecting it into vessels, as this is the most expeditious and 
satisfactory method of fumigating a ship.* 

An essential part of the disinfection of a ship will consist in the 
thorough cleansing of the bilge. The International Sanitary Conference 
of Rome prescribes that the bilge water shall be pumped out and re- 
placed by sea water at least twice at each disinfection of the vessel. 
This is very well so far as it goes, but we would also recommend that 
after such cleansing, the potent disinfectant, mercuric chloride, be added 

1The New Orleans quarantine establishment is provided with an apparatus of this kind, which 


seems to be well adapted for the purpose. See paper by Dr. Joseph Holt, in the annual report of 
the A. P. H. A. for 1884. 


DISINFECTION. 123 


to the clean sea-water remaining in the bilge in the proportion of one 
pound to the ton of water—estimated. In the case of ships sailing from 
ports infected with yellow fever, it would be a wise precaution, after the 
cleansing of the bilge at the point of departure, to throw the same 
‘amount of mercuric chloride, dissolved in salt water, into the bilge, and 
to add a smaller quantity of the same solution at intervals during the 
voyage. 

Merchandise. Article V, of the Report of the Committee on Disin- 
fectants of the International Sanitary Conference of Rome, says,— 


‘¢V. Disinfection of merchandise and of the mails is unnecessary. 
(Steam under pressure is the only reliable agent for the disinfection of 
rags,—/les chiffons en gros.)” 


We think this statement too broad, especially so far as merchandise is 
concerned which has been on board a ship infected with yellow fever. 
The poison of this disease seems to be capable of self-multiplication on a 
foul ship in tropical latitudes, quite independently of passengers and 
crew. And there is ample evidence that even when no case has 
occurred on an infected ship at sea, those who are engaged in discharg- 
ing her cargo after her arrival in port may be seized with yellow fever 
from breathing the infected atmosphere of the hold. Evidently mer- 
chandise conveyed on such a ship should be disinfected. But it does not 
Seem necessary to break packages which have gone on board in good 
condition, and a thorough fumigation with sulphurous acid gas will be 
sufficient if the unbroken packages are so distributed as to be fairly ex- 
posed to the action of the disinfecting agent. To accomplish this, and to 
effectually disinfect the ship, it will be necessary to discharge the cargo 
at the quarantine station. } 

The collections of the rag-man cannot properly be placed in the same 
category with other merchandise, such as agricultural products, hard- 
ware, new cotton or woollen goods, etc. An exception with regard to 
rags is indicated, but not stated with sufficient precision, in the article 
which we have quoted. There is evidence that small-pox has been not 
infrequently transmitted by rags, and sanitarians are generally agreed 
that it would be very imprudent to admit rags collected in or shipped 
from localities infected with cholera or yellow fever, without first sub- 
jecting them to thorough disinfection. The only practical way of accom- 
plishing this seems to be by means of super-heated steam. To make 
this effective, it will be necessary to open the bales, and spread out the 
rags in such a manner that they may be freely exposed to the action of 
the disinfecting agent, or to inject the steam under pressure into the inte- 
rior of the bale through perforated metal tubes, as is practised at the New 
York quarantine station. 


124 PROPHYLAXIS AGAINST INFECTIOUS DISEASES. 


PART SECOND. 
INDIVIDUAL PROPHYLAXIS AGAINST INFECTIOUS DISEASES. 


The state establishes quarantine stations, to guard against the introduc- 
tion of infectious diseases of exotic origin; and in enlightened countries, 
sanitary officials, under the direction of the central government, or of 


states and municipalities, are charged with the duty of guarding the pub-: 


lic against such diseases. It is generally recognized that this is to be 
accomplished by the isolation of the sick, the use of disinfectants, and by 
general measures of sanitary police. 

One way in which the individual may indirectly protect himself against 
such diseases is by using his influence to have this sanitary service placed 
in the hands of competent men, and in sustaining them in their efforts to 
exclude or stamp out infectious diseases by such measures as have been 
demonstrated by science and experience to be efficient for this purpose. 

But this is not the kind of ‘‘ individual prophylaxis” which we have 
to consider here. The question is, What can the individual do to pro- 
tect himself and those immediately dependent upon him, under the vari- 
ous circumstances in which he may be placed, and especially in the pres- 
ence of an epidemic? 

As the advice we have to give will differ greatly according to the dis- 
ease, we shall pass in review the principal infectious maladies of man, 
and shall attempt to give for each such practical instructions as will ena- 
ble an intelligent person to take all practicable precautions for his own 
protection, and for that of his immediate family. We have first, how- 
ever, to make some general remarks. 

Infectious diseases are contracted by contact with the sick, through 
the medium of infected articles, —‘‘ fomites,”—or by exposure in infected 
localities. 

The evident general rule of prophylaxis is, therefore, to avoid all of 
these sources of infection; but there are circumstances in which this is 
either impossible or unjustifiable. Duty calls the physician and the 
nurse into the sick-room, and no argument based upon self-protection 
can keep the devoted mother from the bedside of her sick child, or the 
wife from giving her personal attention to her husband, or the husband 
to his wife, when stricken by pestilence. Humanity requires that during 
an epidemic the sick shall be cared for, the dead buried, and the foul places 
cleansed. All this calls for the active and intelligent efforts of persons 
who have the courage to face danger, and not only of those who by their 
profession are necessarily brought in contact with the sick,—physi- 
cians, clergymen, sanitary officials, nurses,—but often, also, of volun- 
teers; for, during the prevalence of an epidemic of cholera, or of yellow 
fever, the number of physicians and trained nurses within the infected 
area is commonly insufficient for the care of the sick. 

The history of epidemics shows that brave men and women are to be 


PROPHYLAXIS AGAINST INFECTIOUS DISEASES. 125 


found in every civilized country, who are willing to volunteer for such 
perilous duties ; and also that physicians, and those whose legitimate duty 
it is to care for the sick, very rarely desert their post in time of danger ; 
but the mortality among these brave men and women who stand by their 
guns, and among the volunteers who go to their assistance, is often very 
great. There is a wide-spread notion among people not familiar with 
the facts, that doctors enjoy a certain immunity from infectious diseases 
not possessed by other people, and that the absence of fear is a safeguard 
against infection. Such a supposition is without foundation, and is an 
insult to the brave men and women who fall at their post of duty in every 
epidemic. Courage is no more a protection against disease germs than 
against bullets. It is true, that in epidemics, as in war, the skulkers and 
cowards often run into danger which the men in the ranks escape. The 
rashness which results from ignorance or from thoughtlessness is not 
courage, any more than the prudence which avoids danger when there is 
no good reason for facing it is cowardice. Those who rashly venture 
within the lines drawn by an epidemic, in the pursuit of business or 
pleasure, on the supposition that they will escape the prevailing disease 
because they are ‘‘ not afraid,” often fall victims to their unreasoning 
temerity, and not infrequently beat a hasty retreat, with blanched face, 
when they are brought directly into the presence of the sick and the dying. 

Our advice to the brave is, Do not put your trust in your courage, for 
it is no armor against infection. Rely rather upon those precautions 
which science and experience indicate as best suited to the special cir- 
cumstances in which you may be placed, and do not hesitate to retreat 
before an invisible foe, when you are not required by considerations of 
duty to remain upon the field of battle. If your services are not required, 
you are simply in the way; and if you fall ill, you add to the labors of 
those who devote themselves to the care of the sick. And to the timid 
we would say, Let not your fear control your actions, but look the cir- 
cumstances fairly in the face, and be guided by reason and knowledge, 
or by the advice of those competent to decide for you. A premature 
flight may bring you into ridicule, or into greater dangers than those you 
flee from. Do not let your fears exaggerate the facts, and weigh these 
in the balance of your reason, and not of your apprehensions. The fact 
that Judge A or Col. B has fallen a victim to cholera or yellow fever is 
no more a reason for deserting your home, than is the fact that the hum- 
blest citizen of your town has died from the same disease. 

If courage is no protection against infection, it cannot be denied that 
fear, in the presence of the infectious agent, is a predisposing cause which 
frequently determines an attack, and which may turn the balance in 
favor of a fatal result. The depressing effect of fear is well known, and 
all influences which reduce the vital resisting power of the individual 
predispose to an attack when an epidemic is prevailing. 

Other predisposing causes of a general nature are those conditions of 
enfeebled resistance which result from ill-health, venereal and bacchana- 
lian excesses, etc. 


126 PROPHYLAXIS AGAINST INFECTIOUS DISEASES. 


Of all these, it is probable that excessive indulgence in intoxicating ~ 
drinks is the most potent factor in swelling the mortality returns during 
the prevalence of pestilential diseases. ‘This predisposing cause acts in 
several different ways. The individual whose reason is befuddled by 
drink, stumbles stupidly into all kinds of danger. He is ‘‘ not afraid” 
to sleep upon the ground, exposed to the night air, when yellow fever is 
prevailing, or to quench his thirst with water which a prudent man 
would reject as unfit to drink in the presence of cholera, or to wrap him- 
self in a blanket which has recently been if use by a patient with small- 
pox. Again: the debility, often attended with digestive derangement, 
which follows a recent debauch, constitutes a most favorable condition 
for the reception of the germs of cholera, of yellow fever, and of infec- 
tious diseases generally. ‘Those who use intoxicating drinks habitually, 
but within the limits marked by that mental aberration or loss of reason 
which constitutes intoxication, are less subject to infection than the man 
who is suffering from the effects of a recent ‘‘ spree.” But if they have 
any organic disease of the stomach, the kidneys, or the liver, as a result 
of their habits, this constitutes a predisposition to be attacked, and is a 
very serious complication when an attack is developed. 

Persons suffering from chronic wasting diseases, profuse discharges, or 
recent hemorrhage, are especially liable to become the victims of an in- 
fectious disease during its epidemic prevalence. The same is true of 
those whose vital resistance is below par from insufficient food, or from 
the continued respiration of vitiated air, crowd poisoning, sewer-gas 
poisoning, etc. 

In addition to the predisposing causes mentioned, which furnish indi- 
cations of more or less value with reference to individual prophylaxis, 
there are individual and race differences in susceptibility to certain dis- 
eases manifested by those who are in perfect health. One man may be 
repeatedly exposed to an infectious disease without falling sick, while 
another may suffer several attacks of a disease, such as small-pox, in 
which one attack commonly confers immunity. Race differences in sus- 
ceptibility are shown in the relative immunity of the negro from the 
effects of the yellow fever poison, and the great susceptibility of the same 
race to small-pox. 

We shall now consider in detail the question of individual prophylaxis 
against certain infectious diseases, which, by reason of their fatality and 
occasional wide-spread epidemic prevalence, seem entitled to special 
attention in an essay of this nature. 

Cholera. In Asiatic cholera the danger of infection from association 
with the sick, in the capacity of nurse or physician, is very slight. This 
is amply demonstrated by experience. On the other hand, laundresses, 
who do not come directly in contact with the sick, but who handle cloth- 
ing soiled by their discharges, are liable to contract the disease. By far 
the greater number of cases, however, result from exposure in infected 
localities, and from drinking infected water. Outside of the area in India 
where cholera prevails as an endemic disease, localities become infected 


PROPAYVLAXIS AGAINST INFECTIOUS DISEASES. 127 


and the water-supply contaminated as a result of the introduction of 


infectious material from previously infected localities, either in fomites, 
or through the medium of the discharges of the sick. These facts fur- 
nish the indications for individual as well as for general measures of 
prophylaxis. 

In the sick-room the precautions to be taken are, to keep the room 
clean and well ventilated, to disinfect the discharges of the sick and all 
soiled articles as promptly as possible, and to wash the hands in a disin- 
fecting solution when they have been in contact with the patient or with 
soiled clothing. Attendants should not take their food in the room occu- 
pied by the sick, and should not drink liquids which have been exposed 
in the sick-room. 

The general directions relating to diet, drinking-water, etc., which we 
shall shortly give, apply to the attendants upon the sick, as well as to 
those ata distance from them; and it should be remembered, in the 
interest of the sick, that these attendants do not run any special risks 
beyond those to which all persons within the area of infection are ex- 
posed. Indeed, we may go further, and say that they run far less risk 
when they are in a well regulated hospital and under intelligent supervi- 
sion, than do those persons who dwell in the localities outside of the hos- 
pital from which the cases under their charge have come. 

Attendants upon the sick should have their meals at regular hours, 
should not be deprived of a fair allowance of sleep, and should never be 
allowed to become exhausted by protracted vigils or excessive fatigue. 

When cholera has been introduced into a country and is extending its 
limits from day to day, one of the first questions which will present itself 
to those who are able to change their place of residence will be, whether 
they shall attempt to keep out of its way, and if so, where it is best to go. 
The answer to this question must depend very much upon circumstances. 
Those who are unfortunate enough to live in a city or town which has 
a bad sanitary record, which is not provided with an efficient health 
department, or does not provide money to enable the officers appointed 
to do efficient work, had better decamp in good time, so as to evade the 
foe entirely, or to meet it upon a field more favorable for defensive opera- 
tions. ‘There should be no stampede, and no running away in haste, 
without any definite idea of why and where. The time to go is before 
the disease has fairly obtained a lodgment. Consider that if the season 
is not far advanced, and the town is in an unfavorable sanitary condition, 
there is every reason to anticipate that the first cases will be followed by 
a severe epidemic, and decide at the outset whether you will put your 
castle in order to stand a siege, trusting to well considered measures 
of individual prophylaxis, or whether you will beat a masterly retreat in 
advance of the first assaults of the enemy. Those who vacillate in the 
hope one day that the epidemic is on the decline, and in the fear the 
next that it will sweep everything before it, in the end very often stay, 
when they could just as well have gone, and at the same time neglect 
those precautions which they should have taken at the outset if they had 
decided to stay. 


128 PROPHYLAXIS AGAINST INFECTIOUS DISEASES. 


To those who are unable or unwilling to desert their homes, we would 
say, that when proper precautions are taken the danger is really not very 
great, and that sanitarians look for the day when cholera will be practi- 
cally banished from civilized countries. See that your premises are in 
good sanitary condition, and do what you can to induce your neighbors 
and the authorities in-your town to prepare for the storm. Look espe- 
cially after the plumbing of your houses, and if there is a cesspool or a 
privy vault upon your premises, see that it is kept in good condition by 
the use of antiseptics and deodorants. Above all, be sure that no food 
comes into your house except such as is sound and good, and that the 
drinking-water used by your family is beyond suspicion. Well-water is 
always open to suspicion, and in general, during the prevalence of chol- 
era, it will be advisable to doz all water used for drinking purposes. 
This is a prophylactic measure of prime importance, and there is good 
reason to believe that if faithfully executed it would, to a great extent, 
limit the ravages of the Asiatic pestilence. Tea and coffee recently made 
can be taken with impunity. Milk, during the prevalence of an epidemic, 
should be boiled before it is used as food. Mineral waters, if bottled at 
places distant from the infected area, may be drunk in moderation. A 
moderate amount of sound wine, which was bottled prior to the epi- 
demic, may be permitted to those who are in the habit of using it. 
Those not in the habit of using stimulants should not resort to their use 
during the progress of an epidemic. Those accustomed to them should 
restrict their libations within moderate limits, and will find a little brandy 
and soda, or Appolinaris water, to be better than wines, and especially 
than the acid wines, which are apt to derange the digestion. 

Food should be plain and well cooked, and should be taken in moder- 
ate quantities. Intemperance in eating is quite as bad as intemperance 
in drinking. Soups, meats, and vegetables should always be served hot, 
and should not be put aside for a future repast, or, if served a second time, 
should be brought to the temperature of boiling water shortly before they 
are eaten. Pastry and rich puddings, and all coarse and indigestible 
meats and vegetables, are to be avoided. Sound, ripe fruit, which has 
been brought to the house with the outer skin unbroken, may be eaten 
in moderation by those who know by experience that it agrees with them. 
It should be carefully washed before it is eaten. Melons, cucumbers, 
unripe apples, peaches, or pears, acid fruits generally, and, in short, all 
those articles which are known to give rise to digestive derangements in 
the absence of cholera, would better be banished from the supply-list dur- 
ing the prevalence of this disease. 

Next to the precautions relating to food and drink, we would place © 
those relating to personal habits and clothing. The bowels should not 
be allowed to become constipated, and, on the other hand, any tendency 
to diarrhcea should at once receive attention. This is a matter of the 
greatest importance, and, indeed, is second to none other in individual 
prophylaxis. Absolute rest, a light diet, and a dose or two of chloro- 


1 See Part First of this essay for details relating to the use of these agents. 


PROPHYLAXIS AGAINST INFECTIOUS DISEASES. 129 


dyne, or of Hope’s mixture, or of any approved combination of an opiate 
and an astringent, will usually suffice to control a slight diarrhea, even if 
it is ofa choleraic character. 

The clothing should be suited to the season, but great care must be 
taken that it is warm enough at all times to prevent the body from be- 
coming chilled. A broad flannel belt worn about the abdomen is recom- 
mended by some physicians of experience, and may be useful. Baths 
should be taken at frequent intervals, but should not be too prolonged or 
too cold, and should be followed by a vigorous rubbing of the surface, to 
establish reaction. Excessive exercise and fatiguing labor of all kinds 
are to be avoided. One should never feel ‘‘ done up,” as a result of his 
exertions in the way of business or of pleasure, for the lassitude resulting 
from over-exertion, like that which results from fear, predisposes to an 
attack. Mental depression is, so far as possible, to be avoided: grief, 
despondency, and ‘‘ carking care” are recognized as predisposing causes 
in cholera and in other infectious diseases. 

The use of ‘‘ sulphuric acid lemonade ””—that is, of pure water acidu- 
lated with this acid and sweetened to taste—has been recommended as a 
prophylactic, and there is some evidence in favor of its usefulness. We 
would not advise its indiscriminate use, or that of any other prophylactic 
of this nature. When cholera has made its appearance in a dwelling or 
in a public institution, the inmates may be given this, to the exclusion 
of all other drinks. 

Yellow Fever. This disease, like cholera, is contracted in infected 
localities, rather than by contact with the sick. Indeed, it is rarely, if 
ever, communicated directly by a sick person to his attendants. In in- 
fected places the poison seems to be given off from the soil, or from col- 
lections of decomposing organic matter, and we have no definite evidence 
that it is communicated through the medium of food or drinking-water. 
The history of epidemics of this disease shows that when it obtains a 
lodgement in a city or town which is in an insanitary condition, in south- 
ern latitudes and during the summer months, it extends its area and 
invades new localities similarly situated, until frost occurs, or at least 
until the weather becomes comparatively cool in the autumn. Those 
who remain in an infected area, unless protected by a previous attack, 
are almost certain to contract the disease, and much less can be done in 
the way of individual prophylaxis than in cholera. We therefore advise 
all those who can get out of the way of this fatal disease todo so. As a 
tule, there will be plenty of time, after there is evidence that the disease 
has established itself in certain parts of a city, for those who live ata little 
distance from these centres of infection to get away, in a deliberate and 
well considered manner. The occurrence of one or more imported cases 
cannot be taken as evidence that an epidemic will follow, and is no reason 
for deserting one’s home. If proper precautions are taken by the sanitary 
authorities, it is very probable that no evil result will follow such impor- 
tation of the disease. But when these imported cases are followed by the 
occurrence of other cases in the vicinity where they have been sick, or 


ay 


130 PROPHYLAXIS AGAINST INFECTIOUS DISEASES. 


when such local cases occur in the vicinity of the wharves where vessels 
from infected ports discharge their cargoes, or in sailors’ boarding-houses, 
etc., it must be taken as evidence that the disease has effected a lodge- 
ment, and that infected centres have been established, from which an 
epidemic will in all probability be developed, if the season is favorable 
and the city in an insanitary condition. 

An epidemic is not developed so rapidly as in the case of cholera, but 
the disease usually extends its limits in a very deliberate way, and while 
it is claiming its victims in one section of a city, other sections in the im- 
mediate vicinity may be quite healthy. But the territory invaded remains 
infected until cold weather puts an end to the epidemic. Frequently it 
happens that no new cases occur in an infected area for several weeks, or 
even months, for the simple reason that all those who remained to do 
battle with the pestilence have suffered an attack or are protected by a 
previous attack. The epidemic has ceased for want of material, but the 
infection remains, and will manifest itself if unprotected persons venture 
within the infected area from a mistaken idea that there is no more dan- 
ger because there are no longer any cases. 

In this disease, then, the most important point in individual prophylaxis 
is to keep away from infected localities, and from those places where the 
disease is epidemic,—e. 2., Havana, Vera Cruz, Rio Janeiro,—during 
the season of its prevalence. Very many lives have been sacrificed by a 
misplaced confidence in the protection which courage is supposed to af- 
ford against this disease. ‘‘Iam not afraid,” says the merchant whose 
business calls him to an infected city, or the sea-captain who wishes to 
obtain a cargo of sugar in Havana during the summer months. But not 
being afraid does not prevent such persons from being attacked, and the 
mortality at Havana among sailors from northern latitudes is very great. 
There is a tendency in places where the disease is endemic to underrate 
its malignity, and to ascribe every fatal case to some fault on the part of 
the unfortunate victim or his attendants. He was ‘‘ frightened to death,” 
or ‘* was not properly nursed,” or he was ‘‘imprudent,” etc., etc. The 
mortality is no doubt largely influenced by these secondary causes, but 
yellow fever is a malignant disease, which under the most favorable cir- 
cumstances is very fatal to unacclimated strangers within the limits of its 
endemic prevalence, and which in its epidemic extension in new territory 
claims from 30 to 50 per cent., or even more, of those who fall sick, as its 
victims. This being the case, we repeat our advice to all those whose 
duty does not require them to stay on the field of battle, to make an or- 
derly retreat to some place of safety. 

The precautions relating to food and to personal habits do not differ 
materially from those recommended in the case of cholera. The diet 
should be simple, and excesses should be avoided. Less care will be 
necessary with reference to the use of fruits and vegetables ;—indeed, they 
are rather to be recommended, as better suited than animal food to the 
warm latitudes in which this disease prevails. Constipation should, 
above all things, be avoided; and if there is evidence that the functions 


ie 
— 


PROPHYLAXIS AGAINST INFECTIOUS DISEASES. 131 


of the liver or kidneys are imperfectly performed, suitable medication 
should be resorted to. | 

There is no special danger from the use of water, if it is from a source 
which ensures it from contamination with organic impurities. Spirituous 
liquors, if used at all, should be taken in great moderation. Nothing is 
more likely to develop an attack than alcoholic excesses, and the habitual 
drunkard is almost doomed to death if he falls sick with this disease. 
Exposure to the direct rays of the sun, excessive fatigue, and venereal ex- 
cesses are all predisposing causes which it is within the province of in- 
dividual prophylaxis to avoid. Exposure to the night air, and especially 
sleeping out of doors near the ground, is recognized by experienced 
physicians in yellow fever regions as an invitation to an attack. Great 
care should be taken to avoid chilling of the body, and it is well to sleep 
as far from the ground as possible. The creoles of Louisiana and of the 
West Indies generally insist upon closing the windows of a sleeping-room 
at night. 

The mortality among natives of tropical climates, and especially 
among those whose habits are good, and who are accustomed to a frugal 
-mode of life, is very much less than among the natives of northern lati- 
tudes, when these come, without any previous ‘‘ acclimation,” within the 
influence of the yellow fever poison. ‘Those who are habituated to life 
in the extreme South enjoy a certain immunity from the effects of the 
poison, which is shown by a lower death-rate rather than by any exemp- 
tion from being attacked. One attack of this disease, as a rule, confers 
immunity from a subsequent attack. 

Individual prophylaxis in an infected city will include the avoidance of 
those localities which give special evidence of being infected, and espe- 
cial care not to visit such localities at night. 

The liberal use of disinfectants in cesspools and water-closets, and a 
perfect state of sanitary police in and around the premises, will constitute 
a most important part of the precautionary measures which every individ- 
ual should take for his own protection and that of his family. A state 
of mental equilibrium, and an intelligent appreciation of the special cir- 
cumstances in which he is placed, and of the various measures of pro- 
phylaxis heretofore indicated, will enable an individual to look the facts 
fairly in the face, and to be governed by the light of reason and of science. 
Unfortunately it too often happens, among the ignorant and degraded, 
that a spirit of bravado, attended with a neglect of the simplest sanitary 
precautions, and a disposition to deny the presence of the dreaded foe, 
prevails during the earlier stages of an epidemic, and that this is followed 
by a disorderly stampede and a disgraceful neglect of the sick, when the 
presence and malignant nature of the pestilence are recognized. 

Small-Pox. This disease is contracted by exposure to emanations 
from the body of the sick, or from articles which have been in use by 
them, or exposed in their vicinity. There is no evidence that the small- 
pox poison multiplies external to the human body, and the indications 
for prophylaxis are therefore quite different from those already given for 


—- er 


132 PROPHYLAXIS AGAINST INFECTIOUS DISEASES. 


cholera and yellow fever. One may eat what he pleases, and wallow in 
filth, when small-pox is prevailing, without contracting the disease, so 
long as he keeps away from the sick, and is not brought in contact with 
any article infected by them. In this disease, however, as in the infec- 
tious diseases generally, previous personal habits will greatly influence 
the result when exposure does occur ; and the disease is more fatal to the 
victims of alcoholism, to those who are poorly nourished, and, in gené 
eral, to those whose vitality is reduced by exposure to noxious effluvia 
from putrefying material, by living in overcrowded and ill-ventilated 
apartments, etc. 

As it is now the universal practice to isolate small-pox patients as soon 
as the disease is recognized, the danger of coming, accidentally, in con- 
tact with them is not great. There is but little danger of infection from 
passing within a few yards of a patient with small-pox in the open air, or 
from passing a building in which cases are under treatment. Unprotected 
persons who enter the sick-room are, however, extremely liable to contract 
the disease ; and the infectious material given off from the patient’s body 
clings most tenaciously to surfaces, to clothing, etc., and may give rise 
to an attack after many months, unless destroyed by disinfection. 

It is evident, then, that individual prophylaxis will include the avoid- 
ance of places which have been occupied by the sick, and of articles used 
by them, unless there is a certainty that they have been thoroughly disin- 
fected. It is probable that an unprotected person, who feels obliged, for 
special reasons, to enter the sick-room, may escape infection by the use 
of an air filter placed over the mouth and nostrils. ‘This should be con- 
structed on the principle of the ‘‘ Tyndal respirator,” in which all inspired 
air is made to pass through a layer of cotton wadding, which arrests sus- 
pended particles. It would be necessary immediately on coming out of 
the room to burn the cotton filter, to bathe the hands and face in a disin- 
fecting solution, and to change the outer clothing. 

It is a general rule in regard to infectious diseases that those who are 
necessarily exposed to them should take the precaution of not going into 
the sick-room with an ‘‘ empty stomach,” or in a condition of exhaustion 
from any cause. A cup of coffee, or a glass of wine and a cracker, may 
be taken if a considerable interval has elapsed since the last regular meal. 

It is well known that against small-pox we have a special measure of 
prophylaxis, which has restricted the ravages of this disease within the 
limits which are left to it by carelessness in regard to the application of 
this measure, or ignorance of its value. Since the famous discovery by 
Jenner, vaccination has become the prophylactic par excellence. 

The immunity conferred by vaccination is, as a rule, complete; but 
there are exceptions to this rule, and vaccinated persons occasionally 
suffer from a modified form of the disease. The statistics of the London 
small-pox hospital show that the mortality among unvaccinated persons 
received into that hospital with small-pox, is 35.55 per cent. ; while the 
mortality among vaccinated persons is less than 7 per cent. No doubt a_ 
large portion of the cases of post-vaccinal small-pox might have been 
prevented by revaccination. 


PROPHYLAXIS AGAINST INFECTIOUS DISEASES. 133 


It is now recognized that the protective influence of vaccination is not 
always of a permanent character, and children who have been success- 
fully vaccinated in infancy should be revaccinated when they reach the 
age of puberty, or sooner, if small-pox is prevailing in the neighborhood. 
The operation is so trifling that it is customary to vaccinate old and 
young, with the exception of those who have been successfully vaccinat- 
ed within a year or two, whenever an outbreak of small-pox occurs. 
This practice is to be recommended, but when the operation has been 
performed in a proper manner, with virus which is known to be reliable, 
it is folly to insist upon a frequent repetition of the vaccination, because 
‘it didn’t take.” Ifthe first vaccination has been completely successful, 
a perfect result from revaccination is not usually obtained ; and the fact 
that no result is obtained must be taken as evidence that the person is 
protected. The prophylactic value of vaccination practised after expos- 
ure to small-pox has been demonstrated, and one who is not entirely cer- 
tain that he is protected by a recent successful vaccination will do well 
to resort to this important prophylactic measure at once, if he has reason 
to suspect that he has been exposed to small-pox. | 

Scarlet Fever. In this disease, as in small-pox, the poison is given 
off from the bodies of the sick, and is not reproduced independently of 
them. As we have no knowledge of any means of protection corre- 
sponding with vaccination, prophylaxis consists solely in keeping out of 
the reach of infection by the sick, or by articles infected by them. 

The sick person may communicate the disease during the whole period 
of his illness and convalescence,—a period which often extends to five or 
six weeks, or even longer than this. Infected clothing, which has been 
packed away for months, may communicate the disease; and there are 
numerous instances on record of its transmission to children at a distance 
from the sick, by healthy persons who have recently come in contact 
with scarlet fever patients. ‘The lower animals, and especially pet cats 
and dogs which may have visited the sick-room unnoticed, or which are 
thoughtlessly given to convalescent children for their amusement, consti- 
tute a great source of danger. Persons who have suffered an attack of 
the disease, or who have but little susceptibility to it, may have a slight 
sore throat as a result of exposure to the scarlet fever poison, and may 
communicate the disease in its more severe form to unprotected children. 
One great difficulty in arresting the progress of an epidemic by isolation 
of the sick and disinfection, results from the fact that these slight and 
often unrecognized cases are frequently allowed full liberty. 

Infection has been traced to milk which had been standing in the sick- 
room, or to the same liquid which had become infected at a dairy where 
scarlet fever had prevailed, and where recent convalescents were permit- 
ted to milk the cows. 

All of these facts point to a most rigid exclusion of susceptible children 
from every possible source of infection. The susceptibility of adults is 
very much less, and, when attacked, they usually have the disease in a 
mild form. But their responsibility extends far beyond the point of 


134 PROPHYLAXIS AGAINST INFECTIOUS DISEASES. 


avoiding the sick for their own protection. ‘Those who are associated 
with susceptible children have no right under any circumstances to visit 
the room of a scarlet fever patient without taking the most thorough pre- 
cautions with regard to the disinfection of their person and clothing 
immediately upon leaving it; and even with these precautions, such a 
visit cannot be justified when it is made simply out of curiosity or friend- 
ship. Only those who are in attendance upon the sick should be allowed 
in the sick-room, and they must be regarded as infected persons, who are 
not to be permitted to come in contact with unprotected children while 
they are engaged in this duty. 

Diphtheria. This is a disease in which the infectious material is 
given off from the surfaces affected, and probably not from the general 
surface of the body. As the usual seat of the disease is the throat and 
the nasal mucous membrane, it is the discharges from these surfaces 
which are especially dangerous. Although adults are much less suscep- 
tible to the disease than children, there have been numerous instances in 
which they have contracted diphtheria by the accidental reception of a 
bit of infectious material directly into the fauces. This is especially lia- 
ble to occur during the operation of tracheotomy ; and several physicians 
have lost their lives in this way, in their efforts to save those of their pa- 
tients by aspirating through the tracheotomy tube. It seems extremely 
probable that the diphtheretic poison—germ—is capable of increase, 
independently of the sick, in damp, foul places, such as sewers, damp 
cellars, and especially under old houses in which the floors come near 
the surface of the ground, leaving a damp, ill-ventilated space. At all 
events, the disease often clings to such houses in spite of the application 
of the usual means of disinfection. There is no doubt as to the influence 
of bad hygienic conditions in maintaining the infection when the disease 
has been introduced, and it is possible that such conditions may, in cer- 
tain cases, originate it. 

Insufficient nourishment, the malarial poison, and insanitary surround- 
ings are predisposing causes to the disease. ‘Those suffering from scar- 
let fever, measles, whooping-cough, and tuberculosis are also especially 
liable to be attacked. As in the case of scarlet fever, mild cases, which 
in the absence of others more pronounced it would be difficult to recog- 
nize as due to the diphtheretic poison, may give rise to malignant diph- 
theria in more susceptible individuals, or in those whose vital resisting 
power is reduced by any of the causes mentioned. 

Prophylaxis will demand complete non-intercourse with the sick, 
avoidance of infected localities, and care to exclude all persons and arti- 
cles coming from such houses from contact with yourself or children. 
The disease is often spread by thoughtless persons who visit the sick- 
room, and even kiss the infected patients, and then, without any precau- 
tions in the way of disinfection, fondle healthy children in other places, 
and perhaps transmit by a kiss the infectious material which has adhered 
to their lips. The possibility of transmission by pet animals is also to be 
borne in mind. 


PROPHYLAXIS AGAINST INFECTIOUS DISEASES. 135 


Tuberculosts. Recent researches have demonstrated that tubercular 


consumption is an infectious disease, and that the sputa of those affected 


with it, injected into susceptible animals, reproduces in them the same 
disease. ‘This sputum is therefore infectious material, and should be 
destroyed by burning, or by the use of chemical disinfectants. There 
would be little danger of infection from the moist masses of sputum, but 
in a desiccated condition this material is liable to reach the lungs of sus- 
ceptible individuals, and to induce the disease. 

It is well known that there is a great difference in susceptibility to 
pulmonary consumption, and that in certain families this disease carries 
off one member after another, while it is unknown in other families. 
Those who have this hereditary predisposition should pay special atten- 
tion to individual prophylaxis. They should avoid intimate association 
with consumptive persons, should live under the best hygienic conditions, 
in dry, well ventilated apartments, and should select an occupation which 
will keep them in the open air, rather than one which keeps,them con- 
fined to the house. Above all, they should avoid the respiration of an 
atmosphere loaded with organic impurities, or with irritating inorganic 
particles—dust of various kinds. Out of door life on the high and dry 
plains in the centre of the continent, or in the mountains, will in most 
instances enable them to overcome the predisposition, if commenced 
before infection and the resulting tubercular lesions have occurred. 

Those who are engaged in occupations which require them to pass 
some hours each day in an atmosphere loaded with dust will do well to 
wear a respirator for filtering the suspended particles from the air ; for it 
is demonstrated that, independently of hereditary predisposition, the res- 
piration of such an atmosphere predisposes to tubercular disease of the 
lungs. 

Typhoid Fever. In this disease, as in cholera, the infectious agent is 
contained in the alvine discharges of the sick. In the interest of self- 
preservation as well as in that of the public good, every individual who 
has charge of cases should see that the evacuations from the bowels are 
thoroughly disinfected before they are thrown out. 

The drinking of water contaminated with such infectious discharges is 
recognized as a very frequent mode of infection ; and individual prophy- 
laxis demands an intelligent consideration of the source from which a 
supply of drinking-water is obtained for personal or family use. If there 
is the least reason to suspect that this supply may be contaminated by 
typhoid material, or if it contains an undue amount of organic impuri- 
ties, it should be rejected entirely, or boiled shortly before it is used. 

Typhoid epidemics have in several instances been traced to using milk 
which had been contaminated by infected water, added to it directly, or 
used at the dairy to wash the vessels containing it. The remedy in this 
case is to verify the purity of the source of supply of all milk used for 


drinking, or to boil it immediately before it is used. 


The water of wells located within the limits of a city or village should 
not, as a rule, be used for drinking purposes, for the soil is almost cer- 


136 PROPHYLAXIS AGAINST INFECTIOUS DISEASES. 


tain to be polluted; and it often occurs that the contents of privy vaults 
and cesspools pass into the same porous stratum of sand or gravel from 
which the well-water is obtained, or that surface drainage finds its way 
into shallow wells. It will be necessary, also, to regard with suspicion 
the water of small streams and ponds which are so situated that they 
may receive the drainage from collections of filth upon their margin. 

Next to impure water we must place impure air as a factor in the eti- 
ology of typhoid fever. There is good reason to believe that the germs 
of the disease may be carried by the foul gases which are given off from 
sewers, privies, etc., when these become infected, and that the disease 
may be induced by the respiration of such a contaminated atmosphere. 
At all events, the breathing of a vitiated atmosphere, and insanitary sur- 
roundings generally, constitute predisposing causes which should be 
avoided. 

In typhoid fever, as in yellow fever and cholera, depressing mental 
emotions, such as grief, despondency, or fear, and physical exhaustion 
from excessive fatigue, insufficient food, etc., are predisposing causes 
which may induce an attack in the presence of the infectious agent. 

Concluding remarks. This chapter might be greatly extended, but, 
having passed in review the principal measures of individual prophylaxis 
against those infectious diseases which are most fatal, we shall not dwell 
upon precautions to be taken in other contagious diseases, such as mea- 
sles and whooping-cough. These precautions will not differ from those 
already recommended in the cases of small-pox and scarlet fever. So, 
too, in regard to the infectious skin diseases. These are communicated 
by personal contact, and rarely occur except among those who neglect 
personal cleanliness, as well as other sanitary laws. Soap and water 
will generally suffice for individual prophylaxis. By avoiding filthy per- 
sons as well as filthy places, the danger of contracting these and certain 
other unmentionable infectious diseases will be reduced to a minimum. 


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IE PREVENTABLE CAUSES OF DISEASE, INJURY, AND 
JEATH IN AMERICAN MANUFACTORIES AND WORK- 


By GEORGE H. IRELAND, 
Spring field, Mass. 


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Copyright, 1886, 


‘ _ By Irvine A. Watson, SEC. AMERICAN PUBLIC “HEALTE 


All Rights Reserved, y 


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THE PREVENTABLE CAUSES OF DISEASE, INJURY, AND 
DEATH IN AMERICAN MANUFACTORIES AND WORK- 
SHOPS, AND THE BEST MEANS AND APPLIANCES FOR 
PREVENTING AND AVOIDING THEM. 


We are aware that the home life of the average American mechanic is 
not what it should be. In considering our subject, we must assume that 
he comes from a clean house, well ventilated; that he has a pure water- 
supply ; that he brings a well nourished body ; that his clothes are clean, 
and duly cared for ;—in fact, his wife’s work ‘‘ should praise her in the 
gates.” 

The location of the factory is an important subject for the workman. 
In the city he is exposed to lung disease from a smoky atmosphere and 
impure air, bad eyes from poor light during the day-time, great danger 
from fire owing to the buildings’ being huddled together, and also from 
the combustible nature of the surroundings. The suburban factory pre- 
sents disease in the shape of malaria and pulmonary troubles, owing to 
the fog that rises from the undrained land, and from fevers from the bad 
or no sewer connection. 

Unfortunately the builders of factories have not that latitude of choice 
open to builders of private residences. ‘The manufacturer has many lim- 
itations, such as water-power, and proximity to railroads and other facto- 
ries. Some, of strict necessity, must be carried on in the midst of thickly 
settled cities. Manufacturers are, however, each year loosening the fet- 
ters that seemingly have bound them, and are exercising more thoughtful 
care in the selection of building sites. They find it profitable to their 


pockets, as well as contributory to the health of their operatives, to erect 


their buildings in moderate sized towns, or in the suburbs, rather than in 
the heart of the great cities themselves. 

The building should be placed upon well drained land, and every pre- 
caution should be taken against any possible trouble from surface or over- 
flow water. These remarks apply also to the adjoining lands, as land 
that fluctuates from overflow to dry soil is a frequent cause of malaria. 

The building should be of brick, and, if possible, only two stories high. 
(A woollen manufacturer, who had the experience of several fires in his 


factory, remarked in our presence ‘‘ that were he to rebuild, he would 


only build two stories high, as then, in case of fire, the hands would feel 
certain of their safety, and make a stubborn fight to subdue the flames.”’) 
The floor timbers should rest on ledges built in the walls. The flooring 
should fit closely, affording no hiding-places for rats. Where noisy occu- 
pations are to be carried on, the floors are to be ** deafened.” Each story 


140 PREVENTABLE CAUSES OF DISEASE, &C. 


isto be high enough to permit of good ventilation without the draft strik- 


ing on the heads of the workmen ; the roof to be of metal or slate; stone ~ 


coping to be used on chimneys and all walls extending above the roof: 
this prevents loose bricks from falling. ‘The cornices should be of sheet 
metal, when stone, brick, or terra cotta is not used; columns to be of 
hard wood or brick, as they will not warp if badly heated; chimneys to 
rest upon their own foundations, starting from the ground; the walls to 
be whitewashed directly upon the bricks. If plastering is required, use 
metallic lathing. The stairs, of easy pitch, are located at each end of the 
building. In long buildings other flights are to be added, so that no per- 
son will be obliged to go over eighty feet to reach a stairway ; the stairs 
to be of iron, excepting the treads and risers, which may be of wood. 
Where women are not employed, omit the risers; each flight to reach 
the story above by a direct flight, no turns to be permitted; the top of 
each flight to be cased in, and a door provided which is to be closed each 
night, and after the exit of the operatives in case of fire. This door is to 
be of plank completely covered with tin, the joints of which are turned 
over. The hinges to the door are to be fastened by bolts passing clear 
through the door. This style of door is the proper one for inside pur- 
poses where one section of the building is divided from the others. This 
door will stand where the ordinary iron door would be curled up and 
drawn out of position by the heat. A scuttle fastened only by a hasp is 
to be placed in the roof over each stairway. This scuttle is reached bya 
flight of steps always in position. Elevators and elevator shafts are the 
causes of many accidents. At the best they are dangerous things, and 
need to be carefully guarded. The shaft forms a direct means of com- 
munication for the flames from the basement upwards; it is ever ready 
for the reception of any thoughtless person. The moving cage or plat- 
form crushes and maims, and the parted rope sends its precious load to 
the bottom of the elevator well, a mangled mass of humanity. The ele- 
vator should have safety self-locking attachments (to operate in case of a 
broken suspension rope), self-closing hatchways, and guards at each 
landing. One person should be designated to run each elevator, and he 
should be held strictly responsible for its proper use. Thus, detailing 
one person for this duty is entirely practicable, even when the elevator 
work is not enough to occupy his time. By a system of gong signals, he 
can be called from his other work to run the elevator when required. A 
good sized gong-bell is located in the elevator well, and strokes call as 
follows: One, basement; two, second floor; three, third floor; four, 
fourth floor; a clanging of several strokes, an emergency call. We have 
seen this plan most satisfactorily carried out for several years. If self- 
closing hatchways are not adopted, a sign marked DANGER should be 
suspended by cords or chains about five feet from the bottom of the ele- 
vator: this gives timely warning to those below of the descent of the 
elevator. Where there are projecting cross timbers in the elevator well, 
their corners should be rounded, in order that nothing may be caught 
under them. All elevators should be provided with automatic shifting 


ith 


PREVENTABLE CAUSES OF DISEASE, &C. I4t 


devices, to operate in case the carriage, from any cause, is left running. 
Ropes and chain falls should have a shifting lever attached to the beam, 
to be operated by a projection just above the hook. This runs the driv- 
ing belt upon a loose pulley in case the winding drum is permitted to go 
too far. Proprietors should insist that all elevator operators, and all who 
ride upon frezghi elevators, maintain the standing posture, as then they 
are in position to use all their faculties in case of accident. It should, if 
possible, be a rule, upon all freight elevators, that only the operator ride. 
Many accidents are the direct result of ‘‘ fooling” upon the slow freight 
elevators, where all are allowed to ride. Ina factory with which we are 
acquainted, they have a very slow freight elevator, taking some two min- 
utes to cover five stories. One warm day, the operator, having to go empty 
from the basement to the top store room, laid down upon the elevator 
platform. His head by some means came in contact with a timber: he 
would have been killed had not his cries quickly attracted the attention 
of one of the foremen, who stopped the elevator. As it was, his scalp 
hung over his face, being held only by a hinge at the forehead. Had he 
been standing upright, the accident could not have happened. 

The annual loss of life in attempting to escape from burning factories 
is appalling, and the subject of fire-escapes demands the most serious 
consideration. Fire-escapes are of many forms. The best ones for gen- 
eral use, and the only kind that can be relied upon where women are 


employed, is the zig-zag iron stair system of ladders with fat treads, the 


whole to be of iron firmly secured to the outside of the building, and ex- 
tending to the roof. Women are extremely sensitive about making any 
seeming exposure of their limbs ;—this fact, coupled with the confusion 
incident to fires, has, in the opinion of experienced persons, rendered the 
ordinary perpendicular ladder next to useless. With the flat treads the 
ladders are converted, practically, into steps; the inclination is easy, and 
an uninjured woman or child may descend in perfect safety, and without 
fear. This style of fire-escape enables a sound person to assist or bring 
down an injured or unconscious one. 

In locating the ladders, select a side of the building that may be safely 
covered by the hosemen standing on the ground. Do not bring the lad- 
ders near the windows of rooms containing extra inflammable material, 
as by so doing the exit may be cut off in case of fire. For high factories, 
where men alone are employed, a good supplementary escape is one 
of the endless chain pattern, the rate of descent being graduated and 
controlled by an escapement or friction governor. ‘These escapes per- 
mit a continuous line of persons to escape, as several may be upon the 
descending chain at a time. ‘This style of fire-escape presupposes a 
strong pair of uninjured arms and hands, and full possession of the men- 
tal faculties. Another pattern of escape is where a belt encircles the 
body, and has a frictional device through which the rope plays, one end 
of which is attached to the window frame. We have seen a man descend 
one hundred feet by this means. This style of escape can have only a 
partial approval. 


142 PREVENTABLE CAUSES OF DISEASE, &C. 


The simplest of all escapes is a rope long enough to reach the ground, 
and attached to the inside of each window sill,—the rope, in loose coils, 
hanging upon a hook or pin, ready to be thrown out in case of danger. 
This simple rope escape is good for many purpospe, but cannot be 
regarded as a safe escape, as an injured person could not descend. 

Where there is danger from sudden explosions or fire, and the build- 
ing is not over three stories high, the ‘‘ sliding poles,” such as are com- 
mon in the fire department houses, may be used. They afford a quick 
means of reaching the ground with comparative safety. Connected with 
the factory office there should be a system of electric bells and speaking 
tubes. In our factory they enter the telephone room at the office. At 
first we had several tubes, but we have found one general tube to be 
more satisfactory. At the office end, clustered around the mouth of the 
speaking tube, are the push-buttons for the electric bells calling the fore- 
men. ‘The foremen, in turn, have a button calling the main office; also 
one for each of the other foremen. By stepping to the tube and operat- 
ing the buttons, one can speak with any or all of the foremen. The ad- 
vantages of this system, in case of fire or other emergency, are apparent 
without further comment. 

The escaping gas and odors from the water-closets are a fruitful cause — 
of disease. The water-closets should all have a good ‘‘ wash,” and be 
trapped under the seat; and another trap should be added to the pipe as 
it nears the sewer. ‘The closets of ordinary construction for the women 
should open from a commodious room, which is to be used as a dressing 
room. The closet for the men should be provided with a lifting sub-cover, 
thus adapting it for either a water-closet or urinal. This suggestion may be 
objected to by some, but observation has convinced us that the combined 
affair is less offensive than the separate system. For if the pans have the 
ventilating tubes connecting with the ventilating shafts, as is now com- 
mon in all good plumbing, the constant wash of the pan will prevent all 
objectionable odors. ‘The seats, pans, and pipes are to rest upon iron 
supports. The seats are to be of hard wood, well filled; no wood-work 
at the front. The floor should slope gently towards the front, and be 
covered with zinc nailed off with round-headed zinc nails, into squares 
of two or three inches on a side. This arrangement permits the free use 
of the mop in cleaning, and suggests a clean place with but little trouble. 
Many prefer the automatic operating valves, but we prefer the common 
method of handle and chain, as then any required amount of water may 
be used. If urinals are used, keep a piece of carbolic soap in each, and 
flush them often. All sinks and wash-bowls should be trapped. Have 
all the pipes in sight, and accessible. Where chemicals are poured 
down the sinks, use cesspools covers. These are circular pieces of 
wood covered on the under side with lead and rubber, and having an 
earthen knob on top. Ventilation should be such that a change of air is 
effected without drafts upon the head of any person. This may be ac- 
complished by placing the top openings, whether into air shafts or to the 
outside, well up, and by keeping the inlet openings well down. Some 


PREVENTABLE CAUSES OF DISEASE, &C. 143 


years ago the writer served as a junior member upon a hall committee 
to overlook the construction of a hall devoted to social meetings. We 
had all suffered in the old hall from bad air and drafts of air, although 
the building was supposed to have an elaborate ventilating system. In 
our new hall we brought the hot air register to the centre of the hall. In 
the wall of the building was placed a register connecting with an air 
chute, which also opened about the centre of the hall. Half round win- 
dows, opening downward, were placed near the ceiling. By manipulat- 
ing the openings according to circumstances, a comfortable, well venti- 
lated hall was secured at any season of the year. A bald-headed person 
could sit under any of the open windows in this hall, and not take cold. 
We believe that the drafts from the ordinary windows cause much sick- 
ness, and that the time will come when our advanced builders will 
imitate the best car builders, and have most of the windows tight, de- 
pending upon special appliances for ventilation. In all cases see that 
the new air is ure azr. Drafts of air cause much trouble in every fac- 
tory of which we have intimate knowledge. Many of these cases may 
be easily overcome. Probably persons do not differ as widely upon 
other physical conditions as upon exposure to currents of air. One man 
may work unaffected in a strong draft, to which his seemingly more 
robust shopmate would take exceptions. In those portions of the coun- 
try where lung troubles and catarrh are common, great care is required. 
The sensitive workman should be permitted, so far as possible, to select 
his location. Paper caps, having two ventilating holes, are useful in 
many cases. 

An important contributor to health is the sunlight. The difference 
between a well and ill lighted factory may be practically illustrated in 
every large city where houses, that once were healthy homes, are now 
sickly ones,—the cause being directly traced to the shutting off of the 
sun’s light by high buildings being erected near them. For fine work, 
where the eyes are constantly used, a north light is best, the workman 
sitting so he receives the light directly in front or at the left hand. This 
will not shade the work while using the right hand. An opposite wall 


is improved by giving it a coat of whitewash; this also gives a good 


background against which to sight work while testing it. An awning 
to each window, although expensive, is the best summer protection we 
have seen. The portions of a building most often neglected as to light 
are the hallways and stairways, and this neglect has produced many 
accidents. 7 

** Double windows” are a protection in winter for exposed locations. 
When used, one light should be hinged for ventilating purposes. 

We think the subject of lightning-rods requires no further considera- 
tion than that they be good ones, and put up in accordance with well 
known laws of safety. Do not place iron articles against them, as they 
may lead the lightning in a dangerous direction. The electricity reaching 
the ground during a thunder-storm is greater than many suppose, as the 
tain-water conductors carry down considerable. A friend of ours re- 


144 PREVENTABLE CAUSES OF DISEASE, &C. 


ceived a severe shock while adjusting a disarranged spout. Ifthe roof 
has any considerable pitch it should be provided with fenders, to break 
up and hold the snow and ice, thus preventing the too often disastrous 
slides. Special pains should also be taken as to the steps. See that the 
drip from the roof or porch does not fall upon them, and, freezing, make an 
icy covering. The steps, if of metal or stone, should, in a northern lati- 
tude, have a wooden covering in winter. Use sand upon the sidewalks and 
steps during an icy time. The weight of the snow itself is often danger- 
ous, even in the case of well constructed buildings, but it becomes more 
dangerous, owing to its increased weight, when saturated with water 
after a heavy rain-fall. In clearing the snow from the roof, see that the 
space where it is thrown is properly roped off and guarded. 

From our own experience we are fully impressed as to danger from 
fire ; and while we have alluded to the subject in other portions of this 
article, there are several matters that require detailed consideration. 

The heating of the building is best done by means of steam-pipes sur- 
rounding the rooms. ‘The pipes should be supported by iron brackets ; 
and in no case are the pipes to come near wood-work, as fires have 
originated from this cause, the assertions of some ill-informed persons to 
the contrary notwithstanding. Where stoves are used they should stand 
in iron base-pieces, the edges of which are turned upward some two or 
three inches: this prevents sparks and loose particles of coal from falling 
on the floor. See that the stove-pipes are securely fastened by wires to 
the ceiling and chimney; that the pipe enters the brick-work flush with 
the flue; and if the pipe is carried through a partition, see that the thim- 
ble keeps the pipe well away from the wood-work. Keep the tops of 
stove and steana-pipe clear of sawdust and dirt, and pile nothing that will 
drip or fall against them. In burning sweepings containing sawdust, do not 
crowd the fire too much with the door closed, as cases are known where 
the flames have, with an explosion, burst from the door when opened to 
put in a fresh supply. One person should, in each room, be directly re- 
sponsible for the care of steam-pipes or stoves, and the ventilation. The 
temperature that will probably be the most acceptable to the majority of 
persons is from 68° to 72°. The lights in each room should be under the 
care of one person: this prevents a general use of matches. Gas-lighting 
should be done with the electric hand-torch, unless all the burners are 
connected with a system of electric wires igniting all at once. The gas 
should be shut off during the day, and after the building is vacated for the 
night, to prevent the leakage, that is always greater or less where the 
piping is extensive. In case of a fire happening when the gas is lighted, 
shut it off as soon as the building is cleared: this will shut off some fuel 
from the flames. The office supply may be drawn from a separate me- 
ter, or that supply-pipe may tap the main pipe between the shut-off and 
the meter. Some special provision should be made for the office, as that 
department requires gas as times when the factory is not running. Se- 
cure gas and kerosene fixtures from swinging against the wall or under 
shelves. Steady all pendent fixtures by means of wires. Place protect- 


PREVENTABLE CAUSES OF DISEASE, &C. 145 


ors over all lights that come near anything overhead. The writer has 
attended at least one fire caused by sparks adhering to the soot upon the 
bottom of a glue-pot; hence the necessity of seeing that the fire is all out 
where the old-fashioned glue-pots are still in use. We advocate the use 
of steam glue-pots, not only for their safety, but for their other advan- 
tages. Oiled rags, saturated cotton waste, and all combustible waste 
material should be collected at the close of each day and deposited under 
the boilers. We know of one large furniture manufactory where several 
fires had occurred from the rags, saturated with filling, which was of an 
exceedingly combustible nature. The proprietors, for their own safety, 
made a change for a less dangerous composition, but at an annual loss 
of $2,500. In our own experience we have seen a smoking fire from 
rags that had been saturated with filling only ninety minutes. 

Ashes and all waste combustible material not at once put under the 
boilers should be deposited in riveted or seamed metallic receptacles, 
having metallic covers, and the whole placed out-doors at a distance from 
the buildings. The fires resulting from smoking have been so numerous 
in the past, that now most well regulated factories have notices posted, 
prohibiting smoking upon the premises. One of the most noted manu- 
facturing establishments in the country, in order to avoid all possibility 
of danger, prohibits a pipe ora cigar being brought into the factory. 
The old-fashioned sawdust spittoon has yielded its full quota of fires, but 
fortunately they have been slumbering ones, breaking out in the dead of 
night, or on Sundays and holidays: so the loss of life to be attributed to 
them is small. All spittoons should be of earthen or of metal. If an ab- 
sorbent is required, use dry earth or ashes, as then, if a match, cigar- 
stub, or other combustible article is thrown in, no danger’follows. 

A special fire-proof building, at a distance from other buildings, should 
be devoted to the oils, turpentine, varnish, and kindred combustible 
stock, only a day’s supply being removed ata time. When the boiler- 
room is left, even though temporarily, see that the openings under the 
boiler are closed. We hada fire in our factory, the result of a fifteen 
minutes absence of the fireman, who left his under door open, also the 
one into the fuel-room. A brisk spring breeze blew out a line of shav- 
ings that formed a pathway for the fire to a bin of very combustible ma- 
terial, and it was only aftera stubborn fight that the building was saved. 
In establishments requiring the use of lenses, see that these articles are not 
left where they will focus. ‘The writer once had a stereoscopic view de- 
stroyed, the instrument holding it being left in a window. Matches 
should be kept in iron self-closing holders, the stock to be kept in cov- 
ered tin or earthen vessels. Keep the yards and surroundings free from 
straw, old cases, and all rubbish. One of the worst fires we ever saw 
Was a second fire catching in some straw by a spark from the original 
fire, a distance away. Keep the yard well wet down in dry times. If 
there is a shaving-chute, see that it is tight, and does not drop any dust or 
shavings till the shaving-bin is reached. This chute is to havea shut-off, 
which is to be promptly closed upon a fire alarm being given. 


yt 7) 
the 
A 
niet § 


146 PREVENTABLE CAUSES OF DISEASE, &C. 


A volume might easily be written upon the dangers from naphtha and 
benzine. Although the temptation is strong to use them, they should be 
banished from the factory. Where printing-presses are used, substitute 
turpentine for cleaning off the rolls. Some of the carburetors in the 
market are very dangerous, from the fact that they use the dangerous 
products of petroleum, which, leaking through the service-pipes, cause 
explosions if a fire or light is present. Keep telegraph and telephone 
poles away from the buildings, as the wires cause the loss of precious 
minutes to the firemen in raising the ladders. 

The system of sprinklers introduced within the past few years affords 
great protection. Perhaps the best evidence we can produce in their 
support is the favorable opinion of the underwriters. Briefly, this system 
consists of pipes extending over the ceilings to the rooms, hall-ways, and 
stair-ways. These pipes are provided with a sprinkler about every eight 
feet. Each of these sprinklers is stopped by a cap held in position by 
fusible solder, melting for ordinary cases at 150° for engine-rooms, or dry- 
houses at 200°. The water pressure being constant, a wetting down is 
assured in case of fire. In our factory we have had two occasions to test 
them. Each time they went off by the heated air or smoke, the live 
flame not reaching to them. Their work was regarded as most satisfac- 
tory. One pattern of the hand-grenade is in our house and in the fac- 
tory. While these articles, perhaps, add another means of security, too 
much dependence should not be placed upon them. 

The public tests of all this class of extinguishers seem satisfactory, but, 
from age or other causes, they seem to lose their power. Five of our 
quart size were thrown at a neighboring fire without checking it. We 
then ran out our private line of hose and stopped it. The automatic elec- 
tric fire alarm sounds a bell when the heat reaches a certain point: this 
makes it an efficient monitor in case of fire. It is of especial value for 
store-rooms and parts of the building not constantly occupied. 

Electric light lines should be well guarded, as fires have resulted from 
their disarrangement. The wires, unless properly protected, are danger- 
ous to the touch when the electric current is on. Accidents have resulted 
from the wires’ being touched. When the fire is the result of a defective 
electric light apparatus, use great caution in applying the water, other- 
wise the person throwing it may be knocked over. Throw the water 
from the pail so it will leave ina mass. If it forms a continuous stream, 
a current is established. We can mention one fire from this cause, where 
two men, in trying to put it out, were repeatedly knocked over, until the 
cause suggested itself, when they threw the water in masses without fur- 
ther trouble till the current at the central supply was shut off. 

The following constitute the fire apparatus outside the building: A 
hydrant with hose attached: the hose is coiled up and safely ‘‘ housed” 
from the weather in a closet erected against the wall. The wrench for 
turning on the water is also hung up in the closet. The door is simply 
buttoned: then any one may use the apparatus in an emergency. Against 
the wall, under a protection from the weather, hang a strong ladder, with 


PREVENTABLE CAUSES OF DISEASE, &C. 147 


spikes at the bottom end, a scaling-ladder having hooks at its upper end, 
anda fire-hook. This hook of iron, with a chain attached, is mounted 
upon a long, stout pole. A rope is attached to the chain. The inside 
portable fire apparatus, distributed at accessible points, consists of tubs 
and pails of water, fire-axes, ropes with hooks attached for drawing up 
hose, and hand fire-grenades (if they can be made to hold their vitality). 
Have at the foot of each flight of stairs a fire-axe, a lantern filled with 
sperm or lard oil, and one or more pails of water. The water in the tubs 
and pails, if in a freezing temperature, is to be saturated with salt. Each 
workman should have his appointed place for fire duty. All the hose 
and hydrant couplings should have couplings corresponding with those 
of the local fire department. 

Dust may be classed under two heads,—first, that ordinarily recog- 
nized as dust, being a miscellaneous collection of fine particles, contain- 
ing more or less decaying matter ; and, secondly, the finely disintegrated 
portions of material thrown off in the mechanical process of manufactur- 
ing. The first is easily managed, so an ordinary regard for neatness ren- 
ders a detailed consideration unnecessary. ‘The steam-pipes are apt too 
often to be neglected, the very fine dust accumulating being thrown off 
and mixed with the atmosphere when the steam is suddenly let on. The 
rooms should be swept after the day’s work is done, using moist sawdust 
for a sprinkling. This keeps the dust down, and the floor will soon dry. 
Mechanical dust is more difficult to manage. The ordinary wood saw- 
dust is now, in the best regulated factories, conveyed by suction, pro- 
duced by a fan-wheel, to a bin, or room adjacent to the boiler-room, 
where it is burned under the boilers, with other refuse. These ducts, 
while serving an admirable purpose, are also dangerous in case of fire, 
furnishing a direct communication to the most inflammable portions of 
the factory, the shut-offs being the only safety. Dust from sanding and 
polishing machines, which are revolving disks, drums, or reciprocating 
Surfaces covered with sand-paper, may be also withdrawn by the air 
blast into a bin or receptacle by itself. Black walnut sawdust is partic- 
ularly offensive to persons of catarrhal tendencies, and needs to be care- 
fully looked after. In case of metals, the dust may be removed from 
in front of the workman by suction or a blast of air. Persons who have 
been troubled from metal dust have been enabled to continue their work 
by growing a moustache, which caught the particles before they could 
reach the nostrils. In large cities and towns, where the water-supply is 
drawn from a common source, the water usually is good, but in isolated 
factories where resource is had to wells, great caution is needed to avoid 
pollution from drains, manufacturing waste, etc. The ice supply is 
hardly at all recognized as a source of danger, yet it is important that the 
ice used come from a clear body of water, and, if not in motion, large 
enough to furnish clear blocks of ice free from dirt. Do not use ice cut 
from small ponds, or the inlets of large ones, as these places are usually 
the dumping-places of dead animals, and other objectionable refuse. 
The most satisfactory method of cooling water we have seen, is where 


148 PREVENTABLE CAUSES OF DISEASE, &C. 


the water flows through block-tin pipes encircling the ice chamber. This 
gives water cold enough for ordinary purposes. Where the work is 
exhaustive, or the weather excessively hot, we recommend that broken 
ice be placed in a non-conducting receptacle. A piece of ice the size of 
a walnut held in the mouth will be refreshing. Before using water or 
ice, rinse the mouth thoroughly. Evidently many of the so-called pros- 
trations by heat should be attributed to the immoderate use of ice-water. 
In most manufacturing establishments there is a considerable amount of 
‘‘ handling” the goods in the process of manufacturing, transporting it 
from one part of the factory to another. This work is generally done by 
cheap and unskilled hands, and many accidents result from the lack of 
skill and the proper appliances for doing the work. Where the rooms 
are on the same level, and the pieces are large and heavy, a track should 
be laid, the rails of which are even with the floor. Upon this track the 
platform car is pushed. A differential pulley block and chain raises and 
lowers the articles holding them at any point. For general factory use 
we have found the platform trucks to give satisfaction. ‘These trucks are 
made of a length to be taken upon the freight elevator. They can 
then be taken up-stairs, down-stairs, run over the connecting bridge 
between buildings, through doorways, and, in fact, in any portion of the 
establishment where it is desired to carry goods. This truck is a wooden 
platform mounted on an iron axle and wheels, with a trail-wheel at each 
end. It has stakes which are removable. The tops of the wheels are 
below the surface of the platform. Some accidents result from hand- 
ling cased goods, because the workmen cannot get hold of them. It is 
difficult to hold a heavy case with the hook found in the hardware stores, 
but with a specially constructed hook our shipper claims he can hold as 
much as two men with the common hooks. Ours has a good point. 
The back curve is like the ordinary hook. The forward curve does not 
extend too far out, but enough to give a good leverage on the case or box. 
The handle or shank portion slightly recedes, and is flattened out so as 
to fit nicely between the fingers. The length is about double that of 
ordinary hooks. It is hard work for even a clumsy man to receive a 
‘‘ pinch ” while using this hook. 

Do not start the engine during the noon hour, or at other times whem 
not expected, without giving due notice, as otherwise there is danger of 
somebody’s being injured if he is cleaning or overhauling the machin- 
ery. There should be a complete code of signals for the engine-room, 
leading from every portion of the factory where machinery is used. The 
gong used should be of a size to be easily heard in the boiler-room, as 
then the stoker can shut off the engine if the engineer is temporarily ab- 
sent. Many distressing accidents happen by persons being caught in the 
shafting and machinery. The prompt stopping of the engine is of the 
utmost importance. In too many shops the engineer is also the steam 
and gas engineer of the establishment, and is more frequently found in 
the shop than in the engine-room. 

Avoid oiling accidents by doing this work out of work hours (when 


PREVENTABLE. CAUSES OF DISEASE, &C. 149 


the shafting is at rest), paying the workman detailed a special price for 
the constant supervision. ‘The jars and motion communicated to the 
workmen by machinery and pounding are more injurious than at first 
supposed. The body absorbs the concussion, and produces a tired feel- 
ing upon all but the most robust. 

The difference between a well and poorly conducted factory is as great 
as between riding in a Pullman and a caboose. Great care is needed 
relating to noise. Workmen on up-stairs floors should be cautioned 
against jumping from the benches to the floor, or dropping tools or heavy 
pieces of work. Sheets of thick rubber are used with good results under 
pounding-blocks, etc., to absorb the jar. Even in well constructed build- 
ings the addition of a special beam or brace will often prevent the trouble 
from jarring machinery. In our factory the annoyance from a fussy jig- 
saw, running at a high rate of speed, was overcome by this method. 
Heavy machinery upon the first floor would best rest upon a separate 
foundation. 

For general purposes the best seats will be found to be the ordinary 
four-legged, wooden-seated stool, with a home-made back added. This 
back is a thin piece of springy board, the top rounded off and bolted to 
the seat and lower round. This seat is easily mounted and dismounted. 
For persons standing or sitting, a foot-rest will be found of great service, 
for, by frequently changing from one foot to the other, the limbs are kept 
ina good condition. This is important to rheumatic and heavy-limbed 
persons. Experience has taught us, that, other things being equal, in 
making a journey we should select a route having cars with side foot- 
rests. 

Saws are the leading element of danger in many factories. Probably 
ninety per cent. of all the accidents are the direct result of the violation 
of that golden rule, ‘‘ Never put your hand éack of a running saw.” A 
piece of wood sticks a little, or a chip lodges at the back of the saw: the 
temptation presents itself for the workman to remove it without stopping 
the saw. He takes the risk, and perhaps carries a mutilated hand 
through life as the result. At the back of medium and large splitting 
Saws, use a ‘‘horn.” This keeps the cut open, and permits the saw to 
do its duty without pinching. Saws, in many kinds of work, may be 
covered, presenting only a slight cutting surface. Many of the circular 
Saws are made for special work, and differ from the old-fashioned type 
in that a certain proportion of the teeth are hooked, instead of pointing 
outward. A workman would be badly mutilated on the former saw by 
his hand’s being drawn in, while the latter would have a negative if not a 
repelling motion. It will be seen why these new saws demand great 
care upon the part of those running them. ‘The foreman of our wood- 
shop says ‘‘ he does not want a man to touch a saw who is afraid of it.” 
He instructs a new hand as to the dangers, how to avoid them, and ex- 
pects a cautious confidence to do the rest. During his administration of 
several years there has not been a serious injury in his department. 

Universal moulding-machines, and others of that class, using a post or 


150 PREVENTABLE CAUSES OF DISEASE, &C. 


cutter-head for holding the cutters, are most dangerous articles. The 
tendency is to draw in anything brought in contact. The general re- 
marks applied to saws apply to these. There is one danger from these 
machines, even to the experienced hand,—that is, he may forget, when 
shifting the knives, to tighten them up if his attention is temporarily 
called away. We had one accident of this nature in our factory. It has 
been said there is not a person who has run one of these machines any 
length of time who has escaped without mutilation or cuts. We cannot 
contradict the assertion from our own knowledge. 

In showing visitors over a manufacturing establishment, request them 
to lay aside their cigars, and impress upon them the importance of con- 
sidering each piece of machinery as in motion. A nicely running saw 
or cutter-head, to many, conveys the idea of an object at rest. | 

Grindstones, if running at a high speed, should be covered. They, as 
well as emery wheels, should be placed in a room by themselves, or in a 
corner, out of the way of the other workmen. Many bad accidents have 
been the result of broken wheels. Fewer belt accidents would occur 
were loose pulleys more generally used, instead of leaving a belt to hang 
on the shaft when not in use, and putting on while running. 

Some workmen have a practice of laying down their tools with the 
cutting end projecting over the edge of the bench. This is done to save 
the cutting surface. A better plan is to lay the tool point away from the 
workman, and resting on pieces of wood onthe bench. We recall a 
case of a marketman, who, leaving his knife pointing outward, jumped 
forward in the act of hanging up some mutton, and received a fatal 
wound. 

The liquor question, in a general way, it may not be proper for us to 
consider, but in its bearings upon factory life it is important. No work- 
man should be permitted to work while under the influence of liquor, 
nor to run a piece of machinery till he has fully recovered from the 
effects of aspree. The chronic disordered condition of some workmen, 
after vacations and holidays, has caused many liberal-minded employers 
to contract the days off to the smallest possible number. 

Accidents arise from amateur railroading, as in many cases the work- 
men act as switchmen or brakemen where side tracks enter the factory 
grounds. If possible, the side track should be in a straight line, as then 
a fair view may be had. Cars should not be moved at all without timely 
instruction and notice. Itis quite common, where there are several cars, 
to leave one or more spaces for a passage-way through. Fatal accidents 
have resulted from pushing the cars together without notice. Reckless 
engineers delight in giving the cars a good ‘‘ kick” in switching, when 
they know a green hand is at the brake. This trick was played upon a 
friend of ours upon his own premises. Had one of his men been at the 
brake, a fatal accident would have been the result. Even with his expe- 
rience and strength, the car reached the dead end with a force that threw 
him from the car, leaving him hanging from the brake by his powerful 
arms. 


PREVENTABLE CAUSES OF DISEASE, &C. I5I 


Machinery kept constantly running, and under inspection, is less liable 
to break down and cause accidents than where it remains idle a good 
portion of the time. 

Where the workmen are of good habits, it is better in depressed times 
to give vacations in turn rather than close entirely, or to give full work 
to only a few. 

We believe in placing a seriously injured person as soon as possible 
under the care of a competent surgeon. In most places a few minutes 
must elapse before such skill is obtainable: hence the importance of such 
intelligent action as will present the patient to the doctor in the best con- 
dition. Concise elementary directions in case of accidents, published 
under medical supervision, are now obtainable in the large cities. These 
are ptinted upon card-board, and at least one of these notices should be 
posted in every factory. To supplement and carry out the medical direc- 
tions recommended, an emergency box should be kept safely in some 
known place, and under the charge of some cool-headed, intelligent per- 
son. The emergency box should contain a few bottles of medicine, such 
as brandy, arnica, etc., prepared by an apothecary, each bottle properly 
labelled. The selection of the medicine should be left to a doctor or to 

an apothecary, who has knowledge of the dangers of the factory. Besides 

the above, each case should contain a Martin’s rubber bandage, and a 
piece of rubber tube for tying ; some small, strong rubber bands. These 
articles are for use in case of bleeding. A box of surgeon’s plaster, cloth 
bandages, sponge, graduated glass (tea and table-spoonfuls), a medicine 
holder with spout, and a folding fan. 

From a lay point of view we think the medical gentlemen have, in their 
instructions, given all that is required where assistance is within easy 
call, excepting the manner of handling. This subject has not received 
the attention it should, as ‘‘kind hands” are often very ignorant and 
clumsy. We believe a series of illustrations, showing the proper man- 
ner of lifting and supporting sick or wounded persons, would be of great 
benefit, not only to the factory, but also for the home. 

A factory located in a good-sized city has the advantages of hospital 
ambulance and police patrol service. Where such wagons are in use, we 
recommend that each factory should own a stretcher fitting the vehicles. 
By this means a disabled person may at once be laid upon a stretcher 
ready for the hospital attendants upon their arrival. For other purposes, 
use a stretcher constructed in accordance with the views of the local 
doctor, not, however, losing sight of the removable handles, by which 
means in severe cases the handles may be removed, leaving the canvas 
upon the bed and under the patient. 

To obtain the dest medical attendance is often a serious matter for the 
disabled mechanic, owing to his lack of funds. The public hospitals in 
the large cities are all that could be expected, but they cannot cover the 
whole, and take care of every one needing medical assistance. Every 
establishment employing one hundred hands or over should organize a 
mutual relief association, for the purpose of paying medical fees and 


I§2 PREVENTABLE CAUSES OF DISEASE, &C. 


nursing. ‘The money could be used for paying for a free bed in some 


hospital. Where this convenience does not exist, an upper room in. 


‘some comfortable building should be secured for the dangerously sick or 
wounded. We think in an establishment of ordinary risk a regular con- 
tribution of ten cents a week will be sufficient to pay all ordinary de- 
mands; any excess to be assessed, but not to exceed twenty five cents in 
any one week. Many workmen regard going to a hospital as but one 
remove from entering a jail. This ignorant idea should be dispelled, and 
would be by an acquaintance with any good hospital where trained nurses 
areemployed. ‘This idea, we feel, is quite common; and more popular 
information is required, so that a man will believe he enters a hospital to 
be cured, and not to die. 

A shop danger (but thanks to local health officers a lessening one) is 
that from contagious diseases. Most American-born workmen recognize 
and respect the benefit of restriction in such cases. Many of foreign birth 
disregard these limitations, and recklessly endanger their fellow-workmen. 
As the latter are almost invariably the ignorant and most superstitious, re- 
lying upon charms rather than upon medical skill to effect a cure, the 
remedy suggested would seem to be,—restraining power first, then popular 
instruction. We consider the subject of personal cleanliness of more im- 
portance than the general shop condition. We know of a painter who 
attributes a large portion of the sickness of his trade to their handling their 
food and face with soiled hands,—his rule being to keep his hands away 
from his mouth unless they are perfectly clean. The hair and whiskers re- 
quire to be kept clean. Few persons are aware how readily they absorb 
and hold impurities and particles from the atmosphere. In cleaning up, 
a few drops of ammonia in warm water will be found an excellent wash 
for the hair and whiskers, as it is, indeed, for the rest of the body. Hot 
water cannot always be conveniently carried over a building. In our 
factory we overcame the difficulty in this way: Our washing-up sinks 
are the ordinary long iron ones. At one end is placed a copper vessel 
‘holding several gallons. A cold-water pipe leads to this vessel, anda 
steam pipe enters it. By turning the steam valve the water may be 
blown up and heated as hot as desired. The hot water from this tank is 
dipped into the basin, and tempered from the independent cold water 
faucet to suit. 

Workmen who bring their dinners should be furnished with facilities 
for heating or making tea or coffee. The refuse of all fruits, peach- 
stones and banana skins in particular, should be thrown into some 
proper receptacle. The floor is a most dangerous place when sprinkled 
with these articles. 

Persons at work over poisonous substances should talk but little while 
at work: by so doing they breathe more through the nose. We have in 
mind a great talker,—a painter,—whose system seemed to be charged 
with the white lead paint which he applied to small articles upon the 
bench before him. His room-mates, of a less gossiping nature, escaped 
seemingly uninjured. The above occurred in a better lighted and venti- 


eS 


PREVENTABLE CAUSES OF DISEASE, &C. 153 


lated paint room than is ordinarily seen. The physician summoned to 
this painter quickly diagnosed the trouble as lead poisoning, and stated 
the cause as readily as though he had been a shop-mate. 

Most factories abreast of the times, whether engaged in metal, 
wood, or textile manufacturing, have special processes in which the use 
of poisonous chemicals is required. These should be kept in glass or 
earthen receptacles, properly labelled with the word ‘ Poison,” the anti- 
dote also being added. The best chemists now furnish their prepara- 
tions thus labelled. 

Economy of space in some buildings requires that the overhead (ceil- 
ing) spaces be used. Where this is done, keep the articles hung up away 
from over the work-benches as much as possible. Use hooks or pins, 
the outer ends of which are the highest. This prevents jars sending down 
the articles hung up. Pack goods on overhanging shelves so they can- 
not be shaken down. Keep tools, flower-pots, etc., off the window-sills, 
unless there is a guard to the window. One of our most respected state 
governors, now in office, once had a narrow escape from a flower-pot 
that fell from an upper window. 

Observation has convinced us that the ordinary set rules, no matter 
how well framed, are distasteful to the average person, and fall short of 
the mark. Our attention was recently called to a set of rules for the 
guidance of a large bindery and printing establishment. It would hardly 
be possible for any one to comply with all of the requirements. One 
rule, however, so covered the whole that we repeat it from memory: 
‘‘An honest day’s work will be required for a full day’s pay.” Any per- 
son who is not willing to comply with this should be discharged. Each 
foreman should be held accountable for those in his immediate depart- 
ment, and he should have authority to discharge for cause. He should 
be consulted in taking on new hands. 

The introduction of special machinery in almost every manufacturing 
department, has, in our opinion, a tendency to dwarf the man mentally, 
less skilled hand-work being required than under the old system. What 
We now consider as a trade was once only a part of a trade. This dwarf- 
ing of the mental faculties requires a counteracting influence, which must, 
we believe, come mainly through reading. We advocate anything that 
will enlarge and improve the mental condition. In view of the above, 
We recommend that each establishment have only the common rules 
posted, such as relate to smoking, elevators, etc., and that all details be 
printed in book form and given to each person employed. This book is 
to convey, in the way of suggestions, what is expected. The ideal must 
not be above the reach of any person in the factory. The truth should 
be advanced, that the interests of employer and employés are identical. 
Each person should feel that he is responsible for not only his own wel- 
fare, but also for that of his shop-mates. We believe such a presentation 
of the case will arouse in each workman an idea of his responsibilities, 
and a purpose to incorporate the suggestions in his daily shop-life. 


, mY | 
raf Rah at 
AL eye ri 


PUBLICATIONS 


OF THE 


American public Health Association. 


The following constitute the published works of the 
Association : 


Volume I—563 pages—contains 48 papers by 44 authors. 
Volume II—552 pages—43 papers by 39 authors. 
Volume III—z41 pages—zg papers by 29 authors. 
Volume IV—396 pages—37 papers by 33 authors. 
Volume V—256 pages—zo papers by 19 authors. 
Volume VI—497 pages—36 papers by 36 authors. 
Volume VII—446 pages—33 papers by 30 authors. 
Volume VIII—359 pages—z1 papers by 20 authors. 
Volume IX—453 pages—26 papers by 26 authors. 
Volume X—536 pages—46 papers by 43 authors. 

A total of 339 different papers by 222 authors, not including 12 presi- 


dential addresses, and many verbatim reports of interesting discussions 


of important questions. 
Volume XI (now in press). 
Lomb Prize Essays, 1885. 


The above constitutes in itself a library upon sanitation, as will be seen 
in the more detailed analysis of the same in the following pages. So 
great has been the demand for these works in this and foreign countries, 
that but a few complete sets remain for sale in the hands of the treas- 


urer. 
? 


= 


17. 


18. 


LIST OF AUTHORS, 


WITH THE TITLES OF THEIR RESPECTIVE PAPERS, IN THE 
FIRST TEN VOLUMES OF THE PUBLICATIONS OF THE 
AMERICAN PUBLIC HEALTH ASSOCIATION, 


VOL. I—AUTHORS, ALPHABETICALLY ARRANGED. 


. ALLEN, NATHAN, M.D., LL. D. 


1. Perfection of Structure in the Human Body as a Leading Element of Hygiene. 
BAILEY, F. K., M.D. 
2. Cholera in Knoxville, Tenn., and Vicinity. 


. BARNARD, F. A. P., LL. D., President Columbia College. 


3. The Germ Theory of Disease in its Relations to Hygiene. 
BEARD, GEORGE M., M.D. 
4. The Longevity of Brain- Workers. 


. BEEKMAN, Hon. JAMES W. 


5. Remarks upon one of the First Principles of Hospital Hygiene. 
BLODGETT, LoRIN, Esq. 
6. Report upon “ Non-Periodic Changes of Heat as an Element in Sanitary Cli 
matology.” 


. BOARD OF HEALTH, of Little Rock, Ark. 


7. Cholera in Little Rock, Ark. 


MCHANDLER,' Co Fer hi DiMe Delo. 


8. Report upon the Sanitary Chemistry of Waters, and Suggestions with regard 
to the Selection of the Water-Supply of Towns and Cities. 


. CLENDENIN, WILLIAM, M. D. 


9. The General Causes of Disease. 


. Cox, CHRISTOPHER C., M.D., LL. D. 


10. A Report upon the Necessity for a National Sanitary Bureau. 


. ERSKINE, JOHN H., M.D. 


11. A Report on Yellow Fever as it appeared in Memphis, Tenn., in 1873. 


. FLINT, AUSTIN, M.D. 


12. Relations of Water to the Propagation of Fever. 


. GILMORE, J. T., M.D. 


13. An Account of Yellow Fever as it prevailed in Mobile and Vicinity in 1873. 


. HARRIS, ExLisHa, M. D. 


14. Practical Conclusions concerning Cholera. Evidence respecting Causes and 
Preventive Measures. 

15. General Health Laws and Local Ordinances considered with reference to 
State and Local Sanitary Organization. 


. HARTSHORN, HENRY, M.D. 


16. What to do against Yellow Fever. 
Hunt, Ezra M., M.D. 
17. The Need of Sanitary Organization in Villages and Rural Districts. 
JANES, EDWARD H., M.D. 
18. Report on the Practical Lessons of the Recent Prevalence of Small-Pox, 
with reference to its Prevention in the Future. 
Jepson, S. L., M.D. 
19. Cholera in Wheeling, West Va., in 1873. 


LIST OF AUTHORS. I59 


19. JUDSON, ADONIRAM B., M.D. 


20. 


21. 


22. 


24. 


38. 


20. History and Course of the Epizodtic among Horses upon the North Ameri- 
can Continent in 1872-73. 
21. Report upon the Course of Cholera through Two Hundred Towns and 
Cities in the Mississippi Valley. 
Leas, C. A., M.D. 
22. A Report upon the Sanitary Care and Utilization of the Refuse of Cities. 
LEBBY, ROBERT, M.D. 
23. Principles and Practice of Quarantine at the Port of Charleston, South 
Carolina. 
MARSDEN, WILLIAM, M.D. 
24. Plan of a Hospital and Cleansing Establishment for the Treatment of 
Cholera, and Guarding against its Introduction at Ports and Places of 
Entrance. 


. MILLER, B. C., M. D. 


25. Cholera as it Prevailed in Chicago in 1873. 
McCLELLAN, Ey, M.D., Assistant Surgeon, U.S.A. 
26. An Account of the Epidemic of Cholera during the Summer of 1873 in 
Eighteen Counties in the State of Kentucky. 


. PERRY, A. W., M. D. 


27. Effectual External Regulations without Delay to Commerce. 


. PETERS, JOHN C., M.D. 


28. The Oaisin and Spread of Asiatic or Bengal Cholera. 


. PETTENKOFER, MAx Von, M. D., of Munich. 


29. What we can do against Cholera. 


. PFEIFFER, CARL, F.A.I. A. 


30. A Report upon Sanitary Relations to Health Principles of Architecture. 


. Quinn, J. J., M.D. 


31. Cholera in Cincinnati, Ohio. 


. RUSSELL, CHARLES P., M.D. 


32. A Reporton a Uniform System of Registration of Causes of Death through- 
out the United States. 


MIRUSSELL,’S. C., M.D. 


33- Some Account of Yellow Fever as it appeared in New Orleans in 1873. 


. SEVIER, W. R., M.D. 


34. Report upon Epidemic Cholera as it appeared at Jonesborough, Tenn. 


. SmirH, HeBer, M.D., Surgeon in charge U.S. M. H. Service, port of New York. 


35. Sailors as Propagators of Disease. 


. SMITH, STEPHEN, M.D. 


36. On the Limitations and Modifying Conditions of Human Longevity, the 
Basis of Sanitary Work. 

37. Local Measures of Prevention and Relief to be adopted during the Preva- 
lence of Epidemic Cholera. 


. SNIVELY, W., M.D. 


38. Report on Asiatic Cholera. 


. STOCKTON-HovuGH, JOHN, M. D. 


39. On the Relative Influence of City and Country Life on Morality, Health, 
Fecundity, Longevity, and Mortality. 


. TONER, JOSEPH M., M.D. 


40. The ite ibation and Natural History of Yellow Fever as it has occurred at 
different times in the United States. 
41. Boards of Health in the United States. 
Van DeEmaAN, J. H., M.D. 
42. Cholera in Chattanooga, Tenn., and Cities South of Nashville, during the 
Summer of 1873. 


39. VAN DER POEL, S. O., M.D. 


43. General Principles affecting the Organization and Practice of Quarantine. 


160 LIST OF AUTHORS. 


40. 
AI. 
42. 
43: 


44. 


Io. 


II. 


12. 


r3. 


14. 


15. 
16. 


17. 


WALKER, Prof. FRANcIS A., Superintendent U. S. Census. ( 
44. The Relations of Race and Nationality to Mortality in the United States. 
WALLER, EL_wyn, A. M., E. M. of the School of Mines, New York. 
45. Report on Disinfection and Disinfectants. 
WHITE, Hon. ANDREW D., President Cornell University. 
46. Sanitary Science in its Relations to Public Instruction. 
WHITE, C. B., M.D. 
47. Report of Cholera in New Orleans. 
WoopwortTH, JOHN M., M.D., Supervising Surgeon U.S. M. H. Service. 
48. Some Defects in the Immigration Service, including one Report of the Board 
of Health. 


VOL. IL—AUTHORS, ALPHABETICALLY ARRANGED. 


. BAKER, HENRY B., M. D. 


1. Report on the Death Rate of each Sex in Michigan, and a Comparison with 
Dr. Farr’s Life Tables of Healthy Districts in England. 


DELL Cy UN ag ites 


2. Perils of the School-Room. 


. BILLINGS, JOHN S., M. D. 


3. Abstract of Special Reports by Army Medical Officers on the Effect of Moun- 
tain Climates upon Health. 
4. Notes on Hospital Construction., 


pS LACKS | 2: thoy los). 


5. Influence of Hereditary Defects on Health, their Prevention and Eradication. 


. BRown, HARVEY E., M. D. 


6. Yellow Fever on the Dry Tortugas. 


. BUSEY, S. C,, M.D. 


7. The Gathering, Packing, and Free Marketing of Fresh Vegetables and Fruits. 


. COMMITTEE, Report of. 


8. Report of Committee on a Sanitary Survey of the United States. 


. Cook, Prof. GEORGE H. 


g. The Drowned Lands of Orange County, N. Y., and Sussex County, N. J.— 
Their Drainage. 


. DEAN, HENRY W., M.D. 


10. Sanitary Principles in Home Architecture. 
DONALDSON, Prof. F. 
11. Influence of City Life and Occupations in Developing Pulmonary Con- 
sumption. 
Dunotrt, T. J., M. D. 
12. Advantages of Small Hospitals or Infirmaries for Manufacturing and Mining 
Towns. 
EATON, DORMAN B., LL. D. 
13. Essential Conditions of Good Sanitary Administration. 
FRYER, B. E., M. D. 
14. Influence of the High Altitudes and Climate of the Table-Land Country of 
the Rocky Mountain Region upon Health and Disease. 
Gross, SAMUEL D., M.D., LL. D., D. C. L. Oxon. 
15. The Factors of Disease and Death after Injuries.—Parturition and Surgical 
Operations. 
HAMBLETON, F. H., C. E. 
16. A Plea for Sanitary Engineering. 
Harris, ELisua, M.D. 
17. Report on the Public Health Service in the Principal Cities and Sanitary 
Works in the United States. . 
Harrison, W. G., Jr., M. D. 
18. Alcoholic Drinks in Relation to Life Insurance. 


18. 


19. 
20. 
ai. 


22. 


23. 


24. 


25. 


26. 
27. 
28. 
20. 
30. 
<3 


a2. 


33- 
34- 
35: 


36. 
37. 


38. 


39- 


LIST OF AUTHORS. 163 


HARTSHORNE, Henry, M.D. 
19. Report on Sanitary Conditions of Watering-Places. 
20. Infant Mortality in Cities. 
Hitcucock, Homer O., M.D. 
21. Relations of Excessive Use of Alcoholic Drinks to Public Health. 
Hunt, Ezra M., M.D. 
22. Building-Ground and Dwelling-Houses in their Relations to Health. 
Hunt, SANFORD B., M. D. 
23. Soil Drainage and Atmospheric Humidity. 
JANEs, Epwarp H., M.D. 
24. Health of Tenement Populations—Sanitary Requirements of their Dwellings. 
Kenpzig, R. C., M.D. 
25. Report on Poisons as Insecticides in Agriculture, and Tests of their Effects. 
on Food Vegetables. 
KERR, Prof. W. C. 
26. Geological and Sanitary Relations of Drainage and Water Supply in No 
Carolina. 
Law, Prof. JAMEs, D.V.S. 
27. Hereditary Entailments in Domestic Animals and in the Human Family. 
28. Report on Malignant Anthrax in Herds and Malignant Pustule in Man (on 
the Wadsworth estate). 
LEE, BENJAMIN, M.D. 
29. Cost of a Great Epidemic to a Great City. 
MAISCH, Prof. JOHN M. 
30. Pharmacy in its Sanitary Relations. 
NoeEL, H.R. M.D. 
31. Sewer-Gas as a Cause of Diphtheria and Typho-Malarial Diseases. 
OrTON, Prof. Epwarp, A. M. 
32. Certain Relations of Geology to the Water-Supplies of the Country. 
Oscoop, SAMUEL, D.D., LL. D. 
33. Health and the Higher Culture. 
PEPPER, WILLIAM, M.D. 
34. The Sanitary Relations of Hospitals. 
SMITH, STEPHEN, M. D. 
35. The Reciprocal Relations of an Efficient Public Health Service and the 
Highest Educational Qualifications of the Medical Profession. 
36. Hospitalism and Hospital Construction. 
Snow, EpwIn M., M. D. 
37. Does Small-Pox become Epidemic, or Spread only by its own Contagion ? 
STEINER, Hon. L. H., M. D. 
38. A Sanitary View of the Question, “ Am I my Brother’s Keeper?” 
STERNBERG, GEORGE M., M.D. 
39. Yellow Fever in Pensacola, Fla., in 1873-4-’5. 
Sturcis, F. R., M. D. 
40. Relations of Syphilis to the Public Health. 
TONER, JOSEPH M., M.D. 
41. The Leading Public Health Questions in the United States. 
VIELE, E. L., C.E. 
42. Principles and Practice of Drainage and Sewerage, in connection with Water- 
Supplies. 
WoopwortH, JOHN M., M.D. 
43. Location, Plan, and Management of Hospitals, including one Report of Com- 
mittee. 


162 LIST OF AUTHORS. f 


Io. 


12. 


13. 


14. 
15. 
16. 


77s 


18. 
19. 
20. 
ar, 


22. 


23. 


24. 


VOL. III—AUTHORS, ALPHABETICALLY ARRANGED. 


+ DELL A, Nails Ds 


1. Marine Hygiene on board Passenger Vessels. 


. BILLInGs, JOHN S., M.D. 


2. Rights, Duties, and Privileges of the Community in relation to those of th — 
Individual in regard to Health. 


. BREWER, Prof. WILLIAM H. 


3. The Gases of Decay, and the Harm they cause in Dwellings, &c. 


. CLAYPOLE, Prof. E. W. 


4. The Popularization of Sanitary Science in Schools. 


. COMMITTEE, Report of. 


5. Report on the Preparation of a Plan for a Sanitary Survey of the United 
States. 


. CROWELL, HENRY G. 


6. Sanitary Regulations relating to Abattoirs. 
FLINT, AUSTIN, M. D. 
7. Food in its relations to Personal and Public Health. 
GARDNER, JAMES T., C. E. 
8. Relations of Topographical Surveys and Maps to Public Health. 


. GARVIN, Lucius F. C., M. D. 


9. Sanitary Requirements in Factories—Injurious Effects of Cotton Factories 
upon the Health of Operatives. 
GiHoNn, A. L., M. D. 
10. The Need of Sanitary Reform in Ship Life. 


. HARRIS, ELISHA, M. D. 


11. Laws, Provisions, and Methods for securing the Benefits of General Vacci- 
nation throughout the Country. 
HorsFoRD, Prof. E. N. 
12. A New Profession in the service of Hygiene. 
HouGH, FRANKLIN B., M.D. 
13. Health Interests in the Preservation of certain Primeval Forests, and the 
Cultivation of Trees. 
Hunt, Ezra M., M.D. 
14. The See Appointments and Outfitting of Dwellingbtogses 
JANES, EDWARD H., M. D. 
15. Abattoirs ae the Slaughtering Business in New York. 
LENTE, FREDERICK D., Jr., M. D. 
16. Florida as a Health Resort. 
LEWIS, CHARLTON T., Esq. 
17. Ancient and Modern Hygiene Contrasted—lInfluence of Civilization on the 
Duration of Life. 
Morris, JOHN, M. D. 
18. Scarlatina in Baltimore and Belair, Md. 
PFEIFFER, CARL, F. A. I. A. 
19. A Report on Methods of Ventilation. 
SEGUR, B. A., M. D. 
20. Privy Vaults and Cesspools. 
SHEDD, J. HERBERT, C.E. 
21. Water-Supplies for Large Institutions and Small Communities, 
SMITH, STEPHEN, M. D. 
22. The Influence of Private Dwellings and other Habitations on Public Hy- 
giene: the Relations of Sanitary Authority to them. 
STEINER, Lewis H., M. D. 
23. Expert Supervision in Construction of Public Institutions. 
WALKER, JEROME, M.D. 
24. Summer Resorts for the Debilitated Children of our Cities. 


LIST OF AUTHORS. 163 


25. WARING, GrEorcE E., Jr. 


25. The Sanitary Condition of Country Houses and Grounds. 


26. WASHBURN, Emory, LL.D. 


27. 


28. 


26. Expert Testimony and the Public Service of Experts. 
Wauirr, C. B., M.D. 
27. Disinfection in Yellow Fever, as Practised in New Orleans—Evidence of its 
Efficacy. 
Woop, EDWARD S., M.D. 
28. Illuminating Gas in its Relations to Health. 


29. WoopwortTH, JOHN.M., M. D. 


29. The Safety of Ships and of those who Travel in them, including one Report 
of Committee. 


VOL. IV.—AUTHORS, ALPHABETICALLY ARRANGED. 


. AMES, AZEL, M.D. 


1. The Removal and Utilization of Domestic Excreta. 


. ANDREW, GEORGE L., M.D. 


2. The Sanitary Value of Forests. 


. AUSTIN, W. G., M.D. 


3. The Epidemic of 1839. 


. BREWER, Prof. WILLIAM H. 


4. Practical Suggestions concerning Tree-Planting for Sanitary Effects. 


5. CHESBROUGH, E. S., C. E. 


II. 


12. 


13. 


14. 


¥ 6: 


5. The Drainage and Sewerage of Chicago. 


. CHOPPIN, SAMUEL, M.D. 


6. History of the Importation of Yellow Fever into the United States from 1693 
to 1878. 


. DELEGATION from Mississippi State Board of Health. 


7. Report of the Delegation from the Mississippi State Board of Health to the 
American Public Health Association. 


. DEXTER, WIRT, Esq. 


8. Public Economy of Sanitary Measures : an Address of Welcome. 
Dunott, T. J., M. D. 
9. Sanitary Safety in Railway Travelling—Suggestions in the Interest of Travel- 
lers and Carriers. 


. GREGORY, J. M., LL. D. 


10. Hygiene and Higher Education. 
HAnp, D. W., M.D. 
11. Epidemic of 1864. 
Harris, EvisHaA, M.D. (chairman). 
12. Report on a Sanitary Survey of the United States (continued). 
13. Report on Plans for Complete and Authentic Records of Deaths and Causes 
of Death in the United States. 
14. Significance of the Recent Epidemic—Duties of the Reem Public Health 
Association. 
HARTSHORNE, HENRY, M.D. 
15. On the Geographical Element in the Etiology of Yellow Fever, and its Bear- 
ing upon Prevention. 
HEREFORD, Rev. Dr. 
16, Public Holidays and Public Health. 
HERRICK, S. S., M.D. 
17. Propositions relative to the Etiology of Yellow Fever. 


16. HEwITT, CHARLES N., M.D. 


18. The Work of Hygiene in the Education of Children in the Common Schools, 
and in the Families and Society in which they Live. 


164 LIST OF AUTHORS. 


17. 


18. 


19. 


20. 


21. 


22. 


& 
- 


N 


3 


33: 


I. 


2. 


Hircucock, Prof. EDWARD. 

19. Hygiene at Amherst College. 
HOo.uipay, D. C., M.D. 

20. Is Efficient Quarantine Possible or Practicable ? 
Hunt, Ezra M., M.D. 

21. How to Study an Epidemic. 


22. The Prophylactic Treatment of Individuals as a Means of Preventing Epi- 


demics of Yellow Fever, or other Infective Diseases. 
JENNINGS, R. G., M. D. 


23. The Quarantine at Little Rock, Ark., during August, September, and Octo- — 


ber, 1878, against the Yellow Fever Epidemic in Memphis and the Missis- 
sippi Valley. 
LE Contre, JOHN L., M. D. 
24. Sanitary Problems: the Proper and Rational Method in which Municipal 
Boards of Health should be Organized. 
LINDSLEY, J. B., M. D. 
25. Report on the Yellow Fever in Nashville, Tenn., September and October, 
1878. 


. LYMAN, HENRY M., M.D. 


26. A Review of the Present State of Exact Knowledge regarding the Causation 
of Epidemic Infectious Diseases. 


. Morris, JOHN, M. D. 


27. History of the Epidemic in Baltimore in 1876, 


- MCCLELLAN, ELy, M. D. 


28. A Study of the Yellow Fever Epidemic of 1876, as it affected the State of 
Georgia. 


. PLUNKET, J. D., M. D. 


29. Disinfection of Sewers by Ozone. 


. RAucH, JOHN H., M.D. 


30. The Sanitary Problems of Chicago. 


. SELDEN, WILLIAM, M. D. 


31. Views on the Subject of Prevention of Yellow Fever. 


. SMART, CHARLES, M.D. 


32. Abstract of a Report on the Spring, Well, and River Waters in the Depart- 


ment of the Platte, made to the Medical Director U.S. Army, under date of 


May 26, 1876. 
33. Abstract of a Report on Certain Points in Medical Climatology. 


. STEINER, Lewis H., M. D. 


34. An Address on the Objects of the Association, and its Claims upon the Peo- 
ple for Sympathy and Support. 
TAYLOR, J. Howarp, M.D. 
35. Memorandum concerning the Refugee Cases of Yellow Fever in Philadel- 
phia, 1878. 
TURNER, 2.0) Aso, MoD. Faen: 
36. Air and Moisture on Shipboard: a Fragment of Applied Physiology. 
VANDEMAN, J. H., M.D. 
37. Yellow Fever as it Existed in Chattanooga, Tenn.—Its Origin, Progress, 
and the Probable Remedy for its Abatement in the Future, including one 
Report of Delegation. 


VOL. V.—AUTHORS, ALPHABETICALLY ARRANGED. . 


BREWER, Prof. W. H. 
1. On Rotting Wood. 
CAMERON, Col. JOHN F. 
z. Camps—Depopulation of Memphis—Epidemics, 1878 and 1879. 


Io. 


II. 
12. 
13. 
14. 


As, 


16. 


17, 
18. 


19. 


LIST OF AUTHORS. 165 


. CAMPBELL, HENRY F., M.D. 


3. The Yellow Fever Quarantine of the Future, as Organized upon the Porta- 
bility of Atmospheric Germs, and upon the Non-Contagiousness of the Dis- 
ease. 


. CHANDLER, J., M.D. 


4. How to Deal with a First Case and Early Cases of Yellow Fever, when, in 
spite of Precautions, it has made its Appearance. 


BMOLARKE, ELIoT C., C.E. 


5. City Scavengering in Boston. 


. CompTon, J. W., M.D. 


6. Underground Sewers. 


. CUMMINGS, JOHN B., M. D. 


7. The Inefficiency of Quarantine in the State of Arkansas during the Year 1879. 


. GIHON, ALBERT L., M.D. 


8. On the Protection of the Innocent and Helpless Members of the Community 
from Venereal Diseases and their Consequences. 


. JAMES, BusHROD W., M.D. 


g. International Quarantine. : 
JANEWAY, EDWARD G., M.D. 
10. Remarks upon Necessity for the Filing in a Public Office of Plans and 
Statements about Certain Matters of House Construction—Upon the Study 
of the Origin of Contagious Diseases, and the Liability to Error in this Di- 
rection—U pon the Necessity for Uniformity in the Publication of Vital Sta- 
tistics. 
11. On Post-Mortem Examinations and their Relations to the Public Health. 
JENNINGS, R. G., M. D. 
12. Quarantine and its Results in the State of Arkansas, 1879. 
MunNROE, Prof. CHARLES E., U.S. N. A. 
13. Action of Vegetable Acids on Tin. 
PLUNKET, J. D., M.D. 
14. Cotton as a Fomite. 
SMITH, STEPHEN, M.D. 
15. History of the Association. 
THOMPSON, Rev. HuGH MILLER. 
16. Method Introduced by the Auxiliary Sanitary Association for Disposing of 
the Garbage of New Orleans. 
THORNTON, G. B., M. D. 
17. Yellow Fever Epidemic in Memphis, 1879. 
WANER, 1. j., M.D. 
18. Etiology of Yellow Fever, with Remarks on Quarantine. 
WARING, GEORGE E., Jr., C. E. 
19. The Sewerage and Drainage of Cities. 
WoOoDHULL, ALFRED A., M.D. 
20. May not Yellow Fever Originate in the United States? 


VOL. VI—AUTHORS, ALPHABETICALLY ARRANGED. 


. ATCHISON, T. A., M.D. 


1. The Disposal of our Dead. 


. BAKER, HENRY B., M.D. 


2. The Relations of Schools to Diphtheria, etc. 


» BELL, A. N., M. D., A. M. 


3. The Relations of Certain Filth Diseases to Cold Weather. 


. BREWER, Prof. WILLIAM H. 


4. On the Action of Muddy Water on Sewage. 


166 LIST OF AUTHORS. 
5: 
6. 


19. 


20. 
at 
aa 
23. 
24. 
25. 
26. 


rs 


28. 


Brooks, Hon. ERASTUS. 
5. What the State owes the People. 
CHAILLA, STANFORD E., A. M., M. D. 
6. A Consideration of the Objections Urged by Some Evolutionists against San- 
itary Laws, etc. 


. CRANE, JAMES, M.D. 


7. The Prevention of Certain Contagious Diseases by Local Boards of Health, 


. DEvRON, GusTAvus, M.D. 


8. Abattoirs. 


. DEWOLF, O. C., M.D. 


9. The Results of Attempting to Check the Spread of Small-Pox in Chicago. 


. DuNGAN, D. H., M.D. 


to. Some Suggestions in regard to Sanitation and the Drainage of Small Cities 
and Towns. 


. EATON, Hon. JOHN. 


11. Sanitation and Education. 


. GALLATIN, JAMES, Esq. 


12. The Tenement-House Reform in the City of New York. 


. GAMGEE, Prof. JOHN. 


13. The Sanitary Urgency of the Florida Ship-Canal. 


. Grips, B. F., M. D. 


14. A New Method of Investigation into the Causes of Yellow Fever, upon the 
Basis of Similar Densities. 


. Hareis, R. B. S., M.D. 


15. Yellow Fever Recognition and Isolation. 


. HARRIS, ELISHA, M. D. 


16. The Domestic Pestilences Viewed with Reference to the Sanitary Warfare 
against them. 


JUMERRICK,'S.'S.,,M2D- 


17. Numerical Sanitation: a Calculus of Subsoil Drainage in New Orleans. 


. Houuipay, D.C., M. D. 


18. Dengue, or Dandy Fever. 
HoriBEcK, HENRY B., M. D. 
19. A Brief Synopsis of “Breakbone” or Dengue Fever, as Prevailing in 
Charleston, S. C., in the Summer of 1880. 

Hunt, Ezra M., M.D. 

20. Our Present and our Needed Knowledge of Epidemics. 
JAMES, BusHROD W., M. D. 

21. Abattoirs Improve the Sanitary Condition of Cities. 
KEATING, J. M., Esq. 

22. The Value of Sanitation from an Economic Standpoint. 
LESTER, F. W., M.D. 

23. Report on Yellow Fever in Key West, Fla., in 1880. 
Moore, RoBERT, C. E. 

24. Storm-Water and House-Drainage in Sewers. 
PINKHAM, J. G., M.D. 

25. The Sanitary Association of Lynn, Mass. 
Porr,) J. My D; 

26. The Condition of the Mexican Population of Western Texas in Relation to 
Public Health. 

PORCHER, F. PEyrE, M. D. 

27. Nature, Cause, Extension, and Relations of Dengue or “ Breakbone ” Fever 
in South Carolina, Summer of 1880; also Contrasted with Yellow and Ma 
larial Fevers. 

ScALEs, T. S., M. D. 

28. Municipal Sanitation as Practised in Mobile for Preventing the Spread of 

Yellow Fever. 


Lid 


‘ 


Fs 
+ ‘ 
A 


& 


LIST OF AUTHORS. 167 


29. SMITH, JOSEPH R., M.D. 
29. Disease among Texas Cattle. 
30. STERNBERG, GEORGE M., M.D. 
30. Yellow Fever and Quarantine. 
31. STORER, HoraTio R., M.D. 
31. Sanitary Protection in Newport. 
32. THomas, J. G., M. D. 
32. Dengue. 
33- THORNTON, G. B., M.D. 
33. Memphis Sanitation and Quarantine, 1879 and 1880. 
34. TURNER, T. J., M.D. 
34. The Hygiene of Emigrant Ships. 
35- WARING, GEORGE E., Jr., C. E. 
35. Storm-Water in Town Sewerage. 
36. Wicut, O. W., M.D. 
36. The Management of Contagious and Infectious Diseases in Milwaukee. 


VOL. VIIL—AUTHORS, ALPHABETICALLY ARRANGED. 


1. ADAMS, J. F. A., M.D. 
I. Malaria in New England. 
2. Brooks, Hon. ERASTUS. 
2. What the People owe to the State. 
3. BurGEss, DANIEL M., M.D. 
3. Practical Experiences in regard to the Infection of Vessels with Yellow Fe- 
ver at Havana. 
4. CABELL, J. L., M.D. 
4. The Rise and Progress of International Hygiene. 
§. CAMPBELL, Prof. JOHN L. 
5. “ The Kankakee:” a Sanitary Problem of Indiana. 
6. CHAMBERLAIN, C. W., M.D. 
6. Malaria in Connecticut. 
7. CurRTIS, W. H., M. D. 
7. The Disposal of the Dead. 
8. Duncan, T. C., M.D. 
8. The Atmospheric Element in Epidemics. 
9. FENNER, EDWARD, Esq. 
9. History of the New Orleans Auxiliary Association. 
10. FoLsoM, CHARLES F., M.D. 
10. The Prevention of Insanity. 
11. FosTER, EUGENE, M.D. 
11. The Municipal Organization of the American Public Health Service. 
12. GARNETT, ALEX. Y. P., M.D. 
12. Observations on the Potomac Marshes at Washington, D.C. 
13. GIHON, ALBERT L., M.D. 
13. Health the True Nobility. 
14. GorGas, A. C., M.D. 
14. Effects of Tobacco on Youths. 
15. HERRICK, S. S., M.D. 
15. Railroad Sanitation, its Objects and Advantages. 
16. The Comparative Vital Movement of the White and Colored Races in the 
United States. 
16. HorLBEck, H. B., M.D. 
17. Scarlet Fever in Charleston, S. C. 
17, Hunt, Ezra M., M.D. 
18. The Contagious Diseases of Domestic Animals. 


168 LIST OF AUTHORS, 
18. 
IQ. 
20. 
21; 
22. 
23. 


24. 


25. 
26. 


27: 
28. 


29. 


30. 


ZO 


. ABBOTT, SAMUEL W., M.D. 


JEFFRIES, B. Joy, M.D. 
19. The Control of Defective Vision on Land and Sea. 
Jones, H. Isaac, M.D. 
20. School Hygiene. 
MILEs, ABIJAH J., M.D. 
21. The Sunstroke Epidemic of Cincinnati, O., during the Summer of 1881. 
NAGLE, JOHN T., M.D. 
22. Suicides in New York city. 
PARTRIDGE, J. M., M.D. 
23. Trichine Spiralis: its History, Pathology, and Diagnosis, 
RUNNELS, Moses T., M. D. 
24. Impure Water and its Dangers. 
SMITH, JOSEPH R., M.D. 
25. Disease among Texas Cattle. 
26. Report of Examinations for Trichine of Hogs killed at San Antonio, Texas. 
SMITH, STEPHEN, M.D. 
27. Maritime Sanitary Service. 
SPEED, JOHN J., M.D. 
28. Inside Sources of Disease. 
TURNER, T. J., M. D. 
29. National and International Sanitary Jurisprudence. 
VAN BIBBER, W. C., M.D. 
30. Two Suggestions concerning Healthy Buildings. 
WHITE, C. B., M.D. E 
31. A Report of the Examination of Hogs at the New Orleans Abattoir, with 
reference to Trichinz Spiralis. 
32. The Yellow Fever Epidemic at New Orleans in 1878. 
WRIGHT, A. R., M.D. | 
33. Memorandum of Probable Cause of an Epidemic of Diarrhoeal Diseases in 
Buffalo, N. Y., in 1881. 


VOL. VIIIL—AUTHORS, ALPHABETICALLY ARRANGED. 


~ 


1. Uses and Abuses of Animal Vaccination. 


DELTA ING) Med. 


2. Sanitary Inspection. 


. Brooks, Hon. ERASTUS. 


3. Sanitary Government—Principles and Facts. 
4. Work of the State Board of Health of New York. 


» CABELL, Js Lay OLD). 


5. A Review of the Operations of the National Board of Health. 


. CANTWELL, A. W., M.D. 


6. A Summer Epidemic of Small-Pox caused by Direct Importation from Ger- 
many. 


. COGGSHALL, BELA, M. D. 


7. Is Tubercular Consumption a Contagious and Parasitic Disease? 


. Compton, J. W., M.D. 


8. Large Combined Sewers dangerous to Public Health. 


. DETWILLER, JOHN W., M.D. 


g. Small-Pox in Bethlehem, Penn., and Vicinity in 1881~82. 


. HIBBARD, JAMES F., M. D. 


10. Propositions concerning Vaccination. 
Homan, E. E., M.D. 
11. Stock Transportation. 


Il. 


12. 


424 


14. 


1a 
16. 


17. 
18. 


19. 


20. 


12. 


13. 


LIST OF AUTHORS. 169 


KEATING, Col. J. M. 
12. The Cremation of Excreta and Household Refuse. 
MILLs, H. R., M. D. 
13. The Immigrant Inspection Service of the National Board of Health at Port 
Huron, Mich., and its Bearing on the Public Health of the West and North- 
West. 
NEWELL, T., M.D. 
14. The Sanitary, Physical, and Educational Advantages of Interior Open-air 
Areas in Large Cities. 
SMITH, JOSEPH R., M.D. 
15. Observations on Texas Cattle, Age, Weight, Temperature, Liver, and Spleen. 
SPEED, JOHN J., M.D. 
16. The Relations of Health Associations to the Practice of Medicine. 
STEVENS, THAD. M., M. D. 
17. A History of Health-Work in Indiana. 
STORER, Horatio R., M. D. 
18. The Newport (Edinburgh) System of Sanitary Protection. 
THORNTON, G. B., M. D. 
19. The Negro Mortality of Memphis. 
WIGHT, O. W., M.D. 
20. Laws Requiring Medical Men to Report Deaths and Cases of Infectious Dis- 
eases to the Public Authorities. 
WILson, T. P., M. D. 
21. Life on Wheels—Its Sanitary Needs. 


VOL. IX.—AUTHORS, ALPHABETICALLY ARRAGNED. 


. BELFIELD, WILLIAM T., M. D. 


1. Swell-Head in Cattle. 


. DEWoLF, O.C., M.D. 


2. Pullman from a State Medicine Point of View. 


. FERGUSON, DAVID, M.D. 


3. Preventable Contagious Diseases. 


. FosTER, EUGENE, M. D. 


4. Report of the Committee on Compulsory Vaccination; also a Supplementary 
Report on the Efficiency and Safety of Vaccination. 


. GIHON, ALBERT L., M. D. 


5. Vital Statistics as Sanitary Monitors. 


» HARGIS, R. B. S., M.D. 


6. The Pensacola Yellow Fever Epidemic of 1882. 


. HERING, RUDOLPH, C. E. 


7. Essential Features of House Drainage, and Practical Points regarding its De- 
sign and Construction. 


PJANES, EH, M.D. 


8. Typhus Fever in New York City. 


. LEEDS, Prof. ALBERT R., Ph. D. 


g. The Adulteration of Foods. 


. LUNDY, CHARLES J., A.M., M.D. 


10. School Hygiene. 


. NEWTON, WILLIAM K., M.D. 


11. The Sanitary Control of the Food-Supply. 
OLDRIGHT, WILLIAM, A. M., M.D. 

12. The Overhead Ventilation of Sewers. 
PARTRIDGE, J. M., A.M., M.D. 

13. Swine Plague, or Hog Cholera. 


170 LIST OF AUTHORS. 


14. 
15. 
16. 


17. 


18, 


19. 
20. 
25 
22. 
22. 


24. 


2c 


26. 


Io. 


PENN, J. W., M. D. 
14. Interrogatories on Malarial Fever. 
PRATT, FOSTER, M. D. 
15. The Increase of Insanity in the United States: its Causes and its Sources. 
RAYMOND, JOSEPH H., M.D. 
16. House Sanitation. 
REEVES, JAMES E., M. D. 
17. The Eminent Domain of Sanitary Science, and the Usefulness of State 
Boards of Health in Guarding the Public Welfare. 

SALMON, D. E., D. V.M. 

18. Texas Cattle Fever: Is it a Chimera, or a Reality ? 
SARGENT, Prof. D. A. 

19. Physical Training. 
SMART, CHARLES, M. D. 

20. On the Prevention of Malarial Diseases. 
SMITH, JOSEPH R., M.D. 

21. Observations on Texas Cattle: Age, Weight, Temperature, Liver, and Spleen. 
STERNBERG, GEORGE M., M.D. 

22. Malaria. 
WATSON, Prof. J. MADISON. 

23. Physical Training. 
WEBB, R. D., M.D. 

24. The Changes of Type which Malarial Fevers have Undergone in Sumter 
County, Ala., from 1833 to 1883. 

Woop, THOMAS F. 

25. The Clinical Thermometer in the Prevention of Malarial (Paludal) Fever, 
especially that Form of it to which Seamen sailing out of South Atlantic 
and Gulf Ports are Liable. 

WooDHULL, A. A., M.D. 
26. The Etiological Association of Organic Matter with Malaria. 


VOL. X.—AUTHORS, ALPHABETICALLY ARRANGED. 


- ALT, ADOLF, M. D. 


1. On Protective Spectacles for Workingmen. 


. BAKER, HENRY B., M. D. 


2. The Relation of the Depth of Water in Wells to the Causation of Typhoid 
Fever. 


. BEUGLESS, JOHN D., Chaplain U.S. A. 


3. Cremation as a Safeguard against Epidemics. 


. BREWER, Prof. W. H. 


4. Glucose in its Sanitary Aspects. 


. Brooks, Hon. ERASTUS. 


5. The Food we eat, the Liquids we drink, and the Adulterations we submit to. 


. CHANCELLOR, C. W., M.D. 


6. The Squalid Dwellings of the Poor—a Social and Sanitary Reproach. 


. ConEry, W. B., M. D. 


7. Sanitary Care in Stock Transportation in the Prevention and Control of 
Texas Cattle Fever. 


» CooK,' WiC.) Ma BD. 


8. Public Health and Legislation. 


. CORNWALL, Prof. H. B. 


9g. Adulteration of Beer. 
CURTMAN, CHARLES O., M. D. 
10. On Heating and Ventilation of Dwellings and School-Rooms. 


LIST OF AUTHORS. 17! 


11. DAVENPORT, BENNETT F., M. D. 


12. 


13. 


14. 


2%. 
16. 


17. 


18. 


19. 
20. 


21. 


22. 


33: 
34. 


11. Adulterations of Food and Drugs. 
ELDER, E. S., M. D. 
12. Sanitary Survey of the School-Houses in Indiana. 
FORMENTO, FELIX, M. D. 
13. School Hygiene. 
Fry, FRANK R., A. M., M.D. 
14. The Manufacturer of Soda-Water from Polluted Well-Water. 
Harris, W. JOHN, M.D. 
15. The Chemical Disposition of Sewage. 
HARTWELL, EDWARD MussEy, M.D., Ph. D. 
16. On Physical Training in the United States. 
HERRICK, S. S., M.D. 
17. The Relation between Underground Sewerage and Filth Diseases. 
HoMAN, GEORGE, M. D. 
18, A Sanitary Survey of St. Louis ; being a Series of Short Papers on Leading 
Public Health Topics, contributed by City Officials and Local Sanitarians. 
19. The Situation, Surroundings, and Soil of St. Louis. Considered from a 
Hygienic Standpoint. 
20. The Leading Local Productive Industries, and their Effect on the Health 
and Lives of their Operatives. 
KEATING, J. M. 
21. The Ultimate of Sanitation by Fire. 
LUEDEKING, ROBERT, M. D. 
22. The Chief Local Factors in the Causation of Disease and Death. 
Moore, RoBErT, C. E. 
23. Sewerage and House Drainage in St. Louis. 
24. Notes upon the History of Cholera in St. Louis. 
Morris, J. CHESTON, M. D. 
25. The Milk-Supply of our Large Cities—The Extent of Adulteration and its 
Consequences—Methods of Prevention. 


. MunrOE, Prof. CHARLES E., U.S. N.A. 


26. The Use of Cotton-Seed Oil as Food and for Medicinal Purposes. 


. NEWTON, WILLIAM K., M.D. 


27. The Sanitary Survey of a House. 


. NIPHER, Prof. F. E. 


28. The Mean Temperature and Climatic Conditions of St. Louis. 


. PARKER, W. THORNTON, M.D. 


29. The Sanitary Management of Railway Cars and Stations. 


. PARTRIDGE, J. M., A. M., M.D. 


30. Protection against Hydrophobia, 


. REEVES, JAMEs E., M. D. 


31. Pollution ‘of the Upper Ohio, and the Water-Supply of the Cities and Chief 
Towns within the first Five Hundred Miles of its Course. 


. RICHEY, S. O., M. D. 


32. Deterioration of Vision in School Children. 


. RoBinson, Major SAMUEL A. 


33. Hygiene of the Habitations of the Poor. 


. ROHE, GrorceE H., M.D. 


34. The Hygiene of Occupations. 


. SMART, CHARLES, M.D. 


35. On the Present and Future of Sanitary Water Analysis. 
SPIEGELHALTER, JOSEPH, M.D. 

36. The Local Milk-Supply—Its Sources and Quality. 
STERNBERG, GEORGE M., M.D. 

37. Disease Germs. 


172 LIST OF AUTHORS. 


35 


36. 


40. 
4I. 


42. 


43 


. THORNTON, G. B., M. D. 
. TURNER, JOHN W., C. E. 


. VAUGHAN, V.C., M.D. 


STEVENS, THAD. M., M. D. 
38. The True ue of Chemical Analysis in Determining the Hygienic Puri a 

of Potable Water. ps 
STEVENSON, JOHN D., Esq. . mY? 
39. Organization of Health Department, Sanitary Balers and the Abate. " 
ment of Nuisances. 


40. Sanitation of the Mississippi Valley. 
41. Street and Alley Paving in St. Louis. 


42. Poisonous or “ Sick”? Cheese. 
VINNEDGE, W. W., M.D. 
43. On the Duration of Infectiousness in Scarlet Fever. 
WARING, GEORGE E.,, Jr., C. E. 
44. The Disposal of Sewage. 
WHITMAN, THOMAS J., C. E. 
45. The Public Water-Supply of St. Louis. 
Wyman, W., M.D. g 
46. Hardships of the Coasting Trade, and Particularly of the Chesapeake Bay F, ; 
Oystermen. 


‘Total number of different authors, . . . . . . . «6 «» +) vm uel 


*Total number a contributed, 9 03.0 ya oes While We pan 335 


cluded in this total. 


CONSTITUTION 
OF THE 


AMERICAN PUBLIC HEALTH ASSOCIATION. 


TITLE. 
I. This Association shall be called ‘‘ Tuk AMERICAN PuBLIC HEALTH 


ASSOCIATION.” 
OBJECTS. 


II. The objects of this Association shall be the advancement of sanitary 
science and the promotion of organizations and measures for the practical 
application of public hygiene. 


MEMBERS. 


III. The members of this Association shall be known as Active and 
Associate. The Executive Committee shall determine for which class a 
candidate shall be proposed. The Actzve members shall constitute the 
permanent body of the Association, subject to the provisions of the con- 
stitution as to continuance in membership. They shall be selected with 
special reference to their acknowledged interest in or devotion to sani- 
tary studies and allied sciences, and to the practical application of the 
same. ‘The Assocdate members shall be elected with special reference 
to their general interest only in sanitary science, and shall have all the 
privileges and publications of the Association, but shall not be entitled 
to vote. 

Delegates from national, state, provincial, and municipal boards of 
health, organized sanitary associations, and the army, navy, and marine 
hospital service, shall be entitled to be enrolled as active members upon 
presentation of their credentials to the Executive Committee. Members, 
not delegates from such bodies shall be elected as follows :— 

Each candidate for admission shall first be proposed to the Executive 
Committee, in writing (which may be done at any time), with a state- 
ment of the business or profession and special qualifications of the per- 
son so proposed. On recommendation of a majority of the committee, 
and on receiving a vote of two thirds of the members present at a reg- 
ular meeting, the candidate shall be declared duly elected a member 
of the Association. The annual fee of membership in either class shall 
be five dollars. 


174 CONSTITUTION. 


OFFICERS. 
IV. The officers shall be a President, a First and Second Vice-Presi- 


dent, a Secretary, and a Treasurer. 
All the officers shall be elected by ballot, annually, except the Secreta- 
ry, who shall be elected for a term of three years. 


PRESIDING OFFICER. 


V. The President, or in his absence, one of the Vice-Presidents, or 
in their absence, a Chairman fro tempore, shall preside at all meetings 
of the Association. He shall preserve order, and shall decide all ques- 
tions of order, subject to appeal to the Association. He shall also 
appoint all committees authorized by the Association, unless otherwise 
specially ordered. 

SECRETARY. 


VI. The Secretary shall have charge of the correspondence and rec- 
ords of the Association; and he shall also perform the duties of Libra- 
rian. He, together with the presiding officer, shall certify all acts of the 
Association. He shall, under the direction of the Executive Committee, 
give due notice of the time and place of all meetings of the Association, 
and attend the same. He shall keep fair and accurate records of all the 
proceedings and orders of the Association; and shall give notice to the 
several officers, and to the Executive and other Committees, of all votes, 
orders, resolves, and proceedings of the Association, affecting them or 
appertaining to their respective duties. 


TREASURER. 


VII. The Treasurer shall collect and take charge of the funds and 
securities of the Association. Out of these funds he shall pay such sums 
only as may be ordered by the Association, or by the Executive Commit- 
tee. He shall keep a true account of his receipts and payments; and, 
at each annual meeting, render the same to the Association, when a 
committee shall be appointed to audit his accounts. If from the annual 
report of the Treasurer there shall appear to be a balance against the 
treasury, no appropriation of money shall be made for any object but the 
necessary current expenses of the Association, until such balance shall 
be paid. 

STANDING COMMITTEES. 


VIII. There shall be the following standing committees: (1) The 
Executive Committee, (2) the Advisory Council, (3) the Committee on 
Publication. 


EXECUTIVE COMMITTEE. 


IX. The Executive Committee shall consist (1) of the President, First 
Vice-President, Second Vice-President, Secretary, and Treasurer; (2) of 
six active members, of whom three shall be elected annually by ballot, to 


— > ; 
a ” 
Fe a 


CONSTITUTION. 175 


serve two years, and who shall be ineligible to reélection for a second 
successive term ; and (3) of the ex-Presidents of the Association. 

It shall be the duty of the Executive Committee to consider and recom- 
mend plans for promoting the objects of the Association; to authorize 
the disbursement and expenditure of unappropriated moneys in the 
treasury for the payment of current expenses ; to consider all applications 
for membership, and, at the regular meetings, report the names of such 
candidates as a majority shall approve; and, generally, to superintend 
the interests of the Association, and execute all such duties as may, from 
time to time, be committed to them by the Association. At least one 
month preceding the annual meeting of the Association, the Executive 
Committee shall cause to be issued to members a notice of such meeting, 
and they are authorized to publish the same in medical, scientific, and 
other periodicals, but without expense to the Association ; and such notice 
shall contain the order of business to be followed at said meeting, and, 
briefly, the subjects to be presented, and the special points of discussion. 


ADVISORY COUNCIL. 


X. The Advisory Council shall consist of one member from each State, 
Territory, and District, the Army, Navy, and Marine Hospital Service, the 
Dominion of Canada, and each of the Provinces, who shall be appointed 
by the President on the last day of each session, and who, besides acting 
as a nominating committee of officers for the ensuing year, to be an- 
nounced at such time as the Executive Committee may appoint, shall 
consider such questions and make such recommendations to the Associa- 
tion as shall best secure the objects of the Association. They shall at 
their first meeting elect from their own number a Secretary, whose rec- 
ord of their proceedings shall be made part of the records of the Associa- 
tion. 


COMMITTEE ON PUBLICATION. 


XI. The Committee on Publication shall consist of the Secretary and 
two active members, selected by the Executive Committee, who shall 
contract for, arrange, and publish, under authority of the Executive 
Committee, the proceedings of the Association, including such papers as 
have been examined and approved by the Executive Committee, or which 
have been submitted to them by the latter for their discretionary action. 


REPORTS AND PAPERS. 


XII. All committees, and all members preparing scientific reports or 
papers to be laid before the Association at its annual meetings, must 
give, in writing, the title of such reports or papers, the time to be occu- 
pied in reading them, and an abstract of their contents, to the Bxecutive 
Committee, at least one week preceding the date of such meeting, to se- 
cure their announcement in the order of business. 


176 CONSTITUTION. 


MEETINGS. 


XIII. The time and place of each annual meeting shall be fixed at the 
preceding annual meeting, but may be changed by the Executive Com- 
mittee for reasons that shall be specified in the announcement of the 
meeting. Special meetings may be called, at any time or place, by con- 
currence of two thirds of the Executive Committee. There shall be no 
election of officers, or change of By-laws, or appropriation of money to 


exceed the amount at that time in the treasury, at such special meeting, © 


except by a vote of a majority of all the members of the Association. 
Whenever a special meeting is to be held, at least one month’s notice 
shall, if possible, be given by circular, to all the members, together with 
the order of business. 


QUORUM. 


XIV. At the annual meeting nine members shall constitute a quorum 
for the election of officers, a change of the Constitution, the election of 
members, and the appropriation of moneys. 


ORDER OF BUSINESS. 


XV. The order of business at all meetings of the Association shall be 
fixed by the Executive Committee, and such order must be completed 
before any other business is introduced, except such order of business is 
suspended by a vote of four fifths present. 


ALTERATION OF CONSTITUTION. 


XVI. No alteration in the Constitution of the Association shall be 
made except at an annual meeting, nor unless such alteration shall have 
been proposed at a previous meeting, and entered on the minutes with 
the name of the member proposing the same, and shall be adopted by a 
vote of two thirds of the members present. 


ia 


OFFICERS AND COMMITTEES 


— OF THE— 


AMERICAN PUBLIC HEALTH ASSOCIATION. 


ORGANIZATION, 1885-1886. 


President, . A : Dr Slenry: Po WALCOTT, / ¢. Cambridge, Mass. 
First Vice-President, . Dr. CHARLES W. COVERNTON, . Toronto, Ont. 
Second Vice-President, . Dr. G. B. THORNTON, , . Memphis, Tenn. 
Secretary, . : ; Dr. IRVING A. WATSON, . a, Contord, Natt. 
DOAOSUTET, 0 : : Dr. J. BERRIEN LINDSLEY, . . Nashville, Tenn. 


(Zx-officio Members Executive Committee.) 


STANDING COMMITTEES. 


EXECUTIVE COMMITTEE. 


(Elective.) 
Major CHARLES SMaRT, U.S. A. 5 : : : . Washington, D. C. 
Dr. HENRY B. BAKER : : , ‘ i . : . Lansing, Mich. 
Dr. PINCKNEY THOMPSON . : . i : : } fenderson, Ky. 
Prof. HOSMER A. JOHNSON - ; . 3 ; : ; Chicago, lll. 
Dr. JOSEPH HOLT : . ‘ ‘ . - : -  MNvew Orleans, La. 
Prof. CHARLES N. HEWITT i : ° . Red Wing, Minn. 
(The ex-Presidents, ex-officio members Executive Committee.) 
Dr. STEPHEN SMITH . , . , . . k : . New York city. 
Dr. JOSEPH M. TONER : ; : . . : . Washington, D.C. 
Dr. EDwIn M. SNow ; : ; 3 i : : Providence, R. I. 
Dr. JOHN H. RAUCH . ° , : . : : Spring field, Il. 
Prof. JAMES L. CABELL : en er : : University of Virginia, Va. 
Dr. JOHN S. BILLINGS ; : , ‘ ; : U.S. Army. 
Prof. ROBERT C. KEDZIE . : ‘ ; : ; : . Lansing, Mich. 
Dr. Ezra M. HUNT . : : ; : d ‘ . . Trenton, NV. F. 
Dr. ALBERT L, GIHON : ; : : : ‘ : : U.S. Navy. 
Dr. JAMES E. REEVES ; : ‘ : . ‘ . Wheeling, W. Va. 


ADVISORY COUNCIL. 
THE PRESIDENT, ¢%-officto. 


Alabama, . : . Dr. JEROME CocuRAN, Modzle. 


Arkansas, . ‘ . Dr. H.C. DuNAVANT, Osceola. 
California, ‘ . Dr. G. G. TYRRELL, Sacramento. 
Colorado, . : . Dr. CHARLES AMBROOK, Boulder. 
Connecticut, . . Prof. C. A. LINDSLEY, Vew Haven. 


Delaware, . : . Dr. L. P. Busu, Wilmington. 


178 


Florida, . 3 
Georgia, 
Illinois, 
Indiana, 

Iowa, 

Kentucky, 
Louisiana, 
Maine, 
Maryland, 
Massachusetts, . 
Michigan, . 
Minnesota, 
Mississippi, 
Missouri, . 
New Hampshire, 
New Jersey, 
New York, 
North Carolina, 
Ohio, 
Pennsylvania, 
Rhode Island, . 
South Carolina, 
Tennessee, 
Texas, 
Vermont, . 
Virginia, : 
West Virginia, . 
Wisconsin, 


Dist. of Columbia, 


U.S. Army, 
U.S. Navy, 


U. S.M. H. Service, 
Domin. of Canada, 


Prov. of Ontario, 
Prov. of Quebec, 


LIST OF OFFICERS. 


Dr. ROBERT B, S. Harais, Pensacola. 
Dr. W. H. ELLiott, Savannah. 

Dr. JoHN H. Raucu, Springfield. 

Dr. C. N. METCALF, /udianapolis. 

Dr. J. F. KENNEDY, Des Moines. 

Dr. WILLIAM BAILEY, Louzsvzlle. 

Dr. GUSTAVUS DEvRON, Vew Orleans. 
Dr. FREDERIC H. GerRIsH, Portland. 
Prof. GEoRGE H. Rouk, Baltimore. 
Dr. S. H. DurGin, Boston. 

Dr. O. W. WIGHT, Detrott. 

Dr. D. W. Hann, S?t. Paul. 

Dr. WIRT JOHNSTON, Fackson. 

Dr. JOSEPH SPIEGELHALTER, S¢. Louts. 
Dr. GEORGE COOK, Concord. 
Dr.WILLIAM K. NEwrTon, faterson. 
Dr. A. NELSON BELL, ew York city. 
Dr. Tuos. F. Woop, Wzlmington. 

Dr. R. HARVEY REED, Mansfield. 

Dr. BENJAMIN LEE, Phzladelphia. 

Dr. CHAS. H. FISHER, Providence. 

Dr. Henry B. HORLBECK, Charleston. 
Dr. CHARLES MITCHELL, /Vashville. 
Dr. R. M. SWERINGEN, Austin. 

Hon. Henry D. Hotton, Brattleboro’ 
Dr. J. F. WINN, 2eichmond. 

Dr. C. T. RICHARDSON, Charlestown. 
Dr. J. T. REEVE, Appleton. 

Dr. SMITH TOWNSHEND, Washington. 


Surgeon JOHN S. BILLINGS, Washington, D. C. 
Medical Director ALBERT L. GrHon, Washington, D. C. 
Surgeon PRESTON H. BAILHACHE, Washington, D. C. 


Dr. W. H. HInGsTON, JZontreal, P. Q. 


Dr. PETER H. BRYCE, Zoronto. 
Dr. F. MONTIZAMBERT, Quebec. 


PUBLICATION COMMITTEE. 


THE SECRETARY, ¢%-0fficio. 


Dr. SAMUEL H. DURGIN 
Dr. GRANVILLE P. CONN 


Boston, Mass. 


Concord, V. H. 


SECTION OF STATE BOARDS OF HEALTH. 


(Created at last meeting; organization to be made at Toronto.) 


SPECIAL COMMITTEES. 


ON STATE BOARDS OF HEALTH. 


Dr. CHARLES N. Hewitt, Secretary State Board of Health of Minnesota. 
Dr. Ezra M. Hunt, Secretary State Board of Health of New Jersey. 
Dr. FREDERIC H. GERRISH, President State Board of Health of Maine. 


LIST OF OFFICERS. 


179 


Dr. J. T. REzvE, Secretary State Board of Health of Wisconsin. 

Dr. JOSEPH HOLT, President State Board of Health of Louisiana. 

Dr. THomAs F. Woop, Secretary State Board of Health of North Carolina. 
Dr. C. N. METCALF, Secretary State Board of Health of Indiana. 

Dr. G. G. TYRRELL, Secretary State Board of Health of California. 

Dr. PETER H. Bryce, Secretary Provincial Board of Health of Ontario. 


ON SCHOOL HYGIENE. 


Prof. EDWARD M. HARTWELL . 
Prof. D. A. SARGENT . 

Dr. SAMUEL W. ABBOTT 

Prof. J. MADISON WATSON . 

. Dr. FELIx FORMENTO 


Baltimore, Md. 
Cambridge, Mass. 
Wakefield, Mass. 
. Elizabeth, N. J. 
New Orleans, La. 


Nots. The chairman is authorized to appoint an additional member from each state, province, etc. 


ON ANIMAL DISEASES AND ANIMAL FOODS. 


Dr. D. E. SALMON, V. S. 

Dr. J. M. PARTRIDGE 

Dr. Ezra M. HUNT 

Prof. JAMES LAW : 

Dr. CHARLES W. Beane Ok 

Dr. JOHN H. RAUCH 

Soret WV. TLAND)... . 

Lt. Col. JosEPpH R. SMITH, fun S. A. 
Dr. W. B. CONERY vie 


ON DISPOSAL OF THE DEAD. 


Dr. JOHN Morris . 

Rev. JOHN D. BEUGLEssS, U. S. Re 
Dr. FELIx FORMENTO 

Dr. JAMES F. HIBBERD . 

Dr. A. N. BELL 

Dr. WILLIAM BAILEY 

Prof. GEORGE H. Rou . 


ON DISINFECTANTS. 


Maj. GEORGE M. STERNBERG, U. S. A. 

Prof, GEORGE H. Rouk . 

Maj. CHARLES SmarT, U.S.A. . 

Bieuy ese AUGHAN 9.06 eae ees 
Dr. JOSEPH H. RAYMOND 

Dr. JOSEPH HOLT . 

Dr. SAMUEL H. DuRGIN .. 


ON DISINFECTION OF RAGS. 


Dr. J. HowARD TAYLOR 

Dr. A. N. BELL 

Dr. Henry B. BAKER Phe 

Dr. CHARLES W. CHANCELLOR .. «+ « -« 


Washington, D.C. 
South Bend, Ind. 
Trenton, N. J. 
lelthaca vive ye 
Baltimore, Md. 
Springfield, Ill. 
St. Paul, Minn. 
San Antonio, Tex. 
St. Louis, Mo. 


Baltimore, Md. 

. Brooklyn, N. Y. 
New Orleans, La. 
. Richmond, Ind. 
New York city. 
Louisville, Ky. 
Baltimore, Md. 


Ba.timore, Md. 
Baltimore, Md. 


. Washington, D. C. 


Ann Arbor, Mich. 
- Brooklyn, N.Y. 
New Orleans, La. 

Boston, Mass. 


. Priladelphia, Penn. 


New York city. 
Lansing, Mich. 
Baltimore, Md. 


180 LIST OF OFFICERS. Sa. 


DrcHENRY ‘BOHORLBECE 5 Siler tele get re pe a ‘Chasietos 3) . 
Dr. JOSEPH H. RAYMOND «6s 6 5 6 +s + nw + s/s OOKIYR yam 
Dr. JOSEPH HOLT.) 20 6 6 4 fee a ee a, Na 


ON ANTISEPTICS IN VACCINATION. 


Dr..THomas F; Woob'.. 7.) (Se, A N. c y 
Dre SAMUEL’ W. ABBOTT ©0056). eo Oe ieee) a iy i een Mass. 1 
Dr D EA SAEMON; Vie S27 O25 eee be ie ee ee) Cea ees Wang D. i 


ON INCORPORATION. 


DroHenry. Pe: WALCOTT, President 20 Ve ha ee Campridge, Mass. ? 
Dr. IRVING A. WATSON, Secretary . . . . . . « « « « Concord, N. H. 
Dr. J. BERRIEN LINDSLEY, 7veasurer . . . . . . . « «Nashville, Tenn. x 
Medical Director ALBERT L. GiHon, U.S.N. . . . . . Washington, D. Cia 
Major CHARLES SMarRT, U.S. AS 2. 2. 2 Wes e 
Hon. ‘JOHN EATON 6 005820 Pe Cn a CH 
Dr. SMITH TOWNSHEND 205. 3 ee ce ee fe we ee Ch 
SAMUEL A. ROBINSON, Esq... « 5-0. 4)» + ee) Wi Sage Gal | 
a 
ON NECROLOGY. ‘t 


The SECRETARY. 


Acid, carbolic (see carbolic) : - - ; A ° ia vacate 
Accidents in oiling machinery : PR Ds Py ey Sal Shee 
provisions against, in Wendiing eiodad . wah te heir 
provisions for, in factories ; . . . . . : 


Affections of the nervous system 
Air, amount of carbonic acid in . 
and cubic space required, amount of, in pachosk: -rooms . : : 
and sunlight should be admitted . 
cubic feet per minute for pupils . . : 
ducts for furnaces 


foul, escape of, how Daied for ; : , ‘ : : . 
how removed : : : 
fresh, and cubic space required, diferent Baurdes'o on . . . 
do children require a smaller amount than adults? . : . 
heating of : : : 


how introduced : 
Parkes and De Chaumont on 
in-coming, velocity of ; 
inoffensive to the sense of smell may ie eibealtitul ; : : . 
proper position for outlets and inlets for . . ; : : : 
supply, source of 
Albumens or proteids . 
Animal foods 
food necessary 
vapors from skin and lange more feaverchs than earner Hed gas 
Anthrax bacilli destroyed by sulphurous acidgas_ _. ‘ ° : 


destroyed by mercuric chloride . ° : : : : 

Davaine’s experiments with the blood of . ‘ ; . . 

Antiseptics . : : . i : P : : ° : 

all are not Bb atseos . ‘ ‘ : . . ; A 

not necessarily disinfectants. ; ‘ ‘ . : ° 

retard the development of bacteria . ° : ° ° ° 

useful, when ; ; “ : - - . : ° 

Arrow-root . : ? : . ° ° : ° : . . 

qualities of good ‘ ‘ : : ; ‘ ° ; , 

Arsenic frequently found in wall-papers . , . . ° : . 

Ashes, how to dispose of in factories . , : ; ° ° : . 

B 

Bacilli . : ; : : , : ° . . . : . 

Bacon, pork, and Pa ‘ : ° ; : : ° ‘ . . 

Bacteria - ‘ ‘ : ‘ : . . . : ; 
agents Bay ere multiplication and not destroy ‘ 
description of : : ; é : ‘ : ‘ ; 

multiplication of . . ‘ ; : : : ° ° : 


182 INDEX. 


Baking-powders e ° ° ° ° ° e 
Barley . : ° : . 


Bath-room, cost Ae ; : : ° - : » > > : 
how heated : : ; . ° ‘ ° ‘ : . 
how supplied with water . : ‘ ; ° ‘ ; . 
Beans and pease . , : : ‘ ; ; ‘ . . 
composition of . : ; 5 ‘ ° : ° 


food value of 
Bedding, disinfection of 
Bed-rooms, attic, not recommended 
basement, always poorly eeawied ith real air 


unhealthy . : 
should not be small . : : : : i : . 

Beef, classification of according to cd ; : y ° ; ‘ : . 
composition of : ; ; : : . 
rules governing the selection be ; : : ‘ : ‘ : . : 

Beef-tea, how made “ 

Beets 

Belgium, amount Gt air ‘gtlowed narpile} in ; . : 

Benzine, dangers from : ; : : ; F ° 

Billings, Dr., “ Ventilation and Heaing” illustrations from. : . . 

on the amount of fresh air required for school children ; : . 

Blinds, how constructed for school-rooms . ; : : ‘ ; . 


Boiling as a disinfectant 

Bone and cartilage 

Books, effect of, upon byesight ‘ é ° : 

Boston, cubic space allowed pupils in ee. a . : ; : ‘ 

Bread . : ; : ° 
adulteration of 


amount of waterin . , ; . : ; , . , . 
changes on standing . ° . : : : : 
essential constituents of . : : ‘ ; é ° : 

good, general properties of i ; 3 ; : : ; s 


raising by aeration : : : , : ‘ ° 
by baking-powders . - 3 ‘ “ , . ° ° A 
by the eae of yeast . : : : . , . : ° 
stale : : 
the food value of 
Brick, absorption of water by 


houses damp unless properly taneenibeed) ; ! ‘ . . . 
Bridgeport, Conn., high school, temperature of rooms’, . . 
ventilation of rooms ‘ $ ; ‘ : . 


Brussels, medical supervision of schools in 
Buckwheat, composition of 
“ Bug-poison ” 


Butter : ; ; : ~ ; : 

amount of casein permissible in ‘ : ; , : ; ; ° 

composition of . f : ‘ : ; , ‘ . : ‘ . 

how to take care of 4 ; ; : . . : ‘ . ° . 

physical properties of ; : ° . ; : o Anis : me i: 
Butterine and oleomargarine A . ; : ° ; ° ° . . . 

CO 

Cabbage ° : : : . : : : Maen. : : . ° 54 
Caffeine ‘ . ° : . ° . ° ° i : Rerey | 
Carbo-hydrates Sait starches Ng Ske TaN eeie eC tee 6 6 


INDEX. 


Carbolic acid as a disinfectant 


in cholera 
not destructive to aoares 
special uses of 


Carbonic acid gas, amount exhaled at diferent eae : 


amount of, in the air 


e 6 


183 


113 
II5 


107 


M5 116, 118, sae) 


not specially dangerous in auanvities take in schoo! -rooms 
tables showing amount observed in different American and 


foreign schools . 
test for 


Carpets objectionable . 

Carrots 

Cartilage and bone 

Caseine 

Cellar floor, how Eide one prot 


should be of concrete 

how constructed for tenement-houses - 
school-house, should be guarded against poneainnian 
should be free from dampness and ground-air 

well supplied with light : 
stairs should lead from the kitchen or pantry . 
wall, how made 
windows, how arranged 


Cereals and grains ‘ 
Cesspools, disinfection of . 


how constructed 
when admissible 


Chairs for school-rooms, how made in Cee 


Charbon, experiments regarding 


improperly constructed for school children 


Charms to prevent disease 


Cheese 


how aired 
in small amounts aids icection 


Chloride of lime (See Lime, chloride of). 


Chocolate 


nutritive value of 


avery mild stimulant . ‘ ; ‘ ‘ : 
how adulterated . : : ; ‘ ; . : 


Cholera 


advice to the public regarding 
and the intemperate . : : 
and unsanitary conditions : ; ‘ : . . 
at sea . 
best Brahfectant 3 Iii 
clothing in connection with 
disinfection in . 

of body Bhar death : 
drinks that may be used during its prevalence 
epidemics of, call for courageous assistants 
food in connection with 
from infected drinking-water . 
fruits to be avoided in 
germ does not form spores 
infectious material should be destroyed i in he ae room 
important to disinfect excreta in ' - 
personal habits in connection with : : ; : 


Gh BEAUTE, 


184 INDEX. 


Cholera, risk to attendants over-estimated .. se) tw we 
sanitary precautions against . : eel) Nel ECR aetna 
should one flee from it . : : 4 ° ° 


e e e e e 

sick-room precautions . : ° : . ° ° . ° ° ° 

spread by impure drinking-water . , : . © | ot) hare aie 

water infected with, easily disinfected . . . POI sh oN Be 
Cistern, how constructed . , : 3 . : ° ° ° ° . 
material to be used in the ConetrncHen Ofoi : ° ° oot Se ae 


overflow trap should be trapped . : : : . . . ° . 
should not connect with any receptacle of filth . . . «© « 


should be cleansed at least once a year : . . ay Lis PIAA. 
should not be built under the house. a ° ° ° ° . ° 
ventilation of . ° . . ° e e e e e ° e e 
water (See Water). 

Classes, size of, in schools . ; : : . - * e ° ° ° 0 ie 


Cleanliness should be the watchword . A . . : ° 
Closets, dry-earth, how made 2). ee ce 
Clothing, disinfection of  . é . ° ‘ ° . 
Cloths used in infectious diseases should be burned . : © el a 


Coal, gases given off in burning oe a eh a i NS ite ae 
Ol a ee tm MMP EMER AC 
Coffee . ; ‘ : . ‘ eaMiNe ‘ ‘ MEN WS) 
Colostrum . ; ¢ : - . ° ° ° ° ° 0 az 
Condiments . : f ; ; ; / 4 ° . ° ° ° oo ae 
Confectionery ov ileta Sei tes) he late 5 ie +) ar 

saulteration an PANT AD w eal ie NS ene 
Consumption (See Tuberculosis). 

from unhealthy house sites . : . . aeate’! am ° . g 

tubercular, in schools. mG se heey 60 CUS ve? + eae 


Contag.on, how spread by pupils oe ele Fe val Ye Oe 
Contagious diseases in schools . . : 
Copper, sulphate of . ; ‘ : : . : . . . . : - 113 


special uses . : ‘ : ° . . ° . . . ° . I15 

Corn, composition of . ; ; 7 4 , ‘ ‘ ° ° ° . - 49 

meal, qualities of ; ; ° , . . ° . ° . n°) 
Corrosive sublimate (See Mercuric eMoHdel: 

as a disinfectant . B . . . . . ° ° ee © 

Cottages, advantages. of es 8. i ow kr 

Courage no protection against infection . : ; : ° . : . «=, cee 

Crab, value of : ( ; ; ; ; . : ° : - 40 

Cubic space and fresh air pete ad different authorities on . ° : . a) 

Cultures, germ, how to start , : 4 5 : : re . - 106 

pure, a test for chemical agents . : 0 i 

Curtains for school-rooms . ; ; : : , : < . ° eo, ue 

Cysticerci develop tape-worms  . ; : ; - : ‘ A . . + hae 

D 

Dandelion . ‘ 4 . . ° ° . - 54 

Davaine’s experiments with the biodd of anthrax 4 . . . . . Re 

Decomposition due to “ germs” . ‘ é f 3 : . . ° . - 102 

Deformities from school-room life ; ‘ : : ° : . » 93 

Deodorants . ; ‘ ; : : 3 ; ‘ ‘ ; . ° ‘ a | Jon 

and disinfectants not synonymous terms . : é : . : . BOR 

in the sick-room : ; 4 ; ; : ; : : : a 

when useful : ; ‘ < : d - ahd aor bai : . 108 

Desks, school-room, how made . I ‘ H ; ‘ é « : 3 aie 

SIZES TEQUITE” ial vil ae y twits ey tel hol eh 


INDEX. 
Diarrhoea caused by drinking hard water . ’ 3 é ° ; : 
Digestive organs, comparative weightof . ; ‘ : : : ‘ 
Diphtheria ; : : : 


adults less susceptible to, than children . : : : 


and filth 2 “ : ‘ A ‘ F 


avoidance of A A ‘ : Rte ay ‘ : 
disinfection in 

germ of ‘ . : ° . . : 

how communicated . : : ; A - ¢ ; 3 
infection from . 4 ! : 

predisposing causes of : : : : : : . : 


spread by impure drinking-water 
Diseases, contagious, rules to prevent spread of, in Aine" 


ashop danger . < ‘ 
how caused by insufficient pure air. at a8 : ‘ i 
infectious, how contracted . : ; 
from micro-organisms . : ° 
individual prophylaxis against . : 
in hospitals should be isolated 
special precautions in ‘ ; : 3 ‘ 4 
power to resist, lowered by foul emanations ’ ‘ 
Disinfectants and deodorants not synonymous terms 
for privies. 7 ; : A : 
Labarraque’s . : : : - : : : : ; 
Littre’s definition of : : : : : : ; : 


some proprietary, untrustworthy 

tested by “ pure cultures” : 
which are effective in the absence ne eNotes ‘ 
which have the power to destroy spores 


Disinfecting solution 
Disinfection . 


and Reenfectints, Wallin « on 
and individual prophylaxis against ifectads ners, : 
cloths used in infectious diseases should be burned 


definition of . é : - ? : 3 
evidence of no value pene eeeivead 3 4 x . . 


general directions for 
in cholera 


inoculation, experiments poorer dita : : ; : 
negative evidence received with caution ° . . ° 
object of . ‘ : ; : ; : 
of body after death Fon cholera : . . ° : : 
of clothing and bedding . : : : . : . , 
excreta, etc. 2 - 
merchandise 
person. : . : 
privy vaults, Resandols: ee : . : . 
rags : : : : ; , : ; ‘ 
ships , : : : : : ° ‘ ‘ 
sick-room : : : : ; , : : 

vacated . é é ; é 
water and articles of food , : : : 


popular understanding of 


something more than the destruction of ae ptomaines 
special means resorted to ; 4 : : , . ; 


tests of 


valueless attempts at - . : . . 3 : : 


186 


Disinfection, what it consists of 
with boiling water 
carbolic acid 


chloride of lime 


chloride of zinc 


dry heat . 


fire 


liquor sod@ Cite aay : 
mercuric chloride (bichloride of ae reuee corrosive =. subiaates 
steam under pressure 
sulphate of copper 
sulphur dioxide (sulphurous ue gas, sulphur) 
Doctors, erroneous notions regarding their immunity from disease 
Doors, glass sliding, for school-rooms 


INDEX. 


school-house, should swing outward 


Drains, brick, in cellar always bad 
earthen, broken by settling 


Drainage of house-site 
rules governing 


Dress, superfluities of, should be veld in Senor, 


Dry heat as a disinfectant 
Dust, classification of . 


mechanical, difficult to manage 
removal of, by air-blast 


e 


Dysentery spread by impure drinking-water 


Earth-closets for school-houses 


2? 


Electric-light lines should not touch paces 


Elevators 


freight, cancers foe 


gong, signal for 


responsible person should run 


should have safety locking attachment 
well, how constructed . 
Engine, before starting, notice should be pen : 


Epilepsy from gymnastics 


precautions against 


Eggs : 
composition of 

how to preserve 
Erysipelas, disinfection in 


to be guarded against in bhenitats : 


Excreta, etc., disinfection of 


Exercise for ‘school children, object of 


Eyes, affections from school-room causes . : 


hygiene of the 


of school children blip in different teentaes 


rules for using the 


Factory, building ofa . 


buildings should be on well Beagle ane 


construction of a 


doors, construction of 


heating ofa . 


E 


e 


112, 


Tia, 


INDEX. 187 


Factory, employés should organize mutual relief associations . ae bie ina 3 


fire-escapes for : ‘ ‘ : ‘ - I4I 
offices should be connected tie ppedaneita with the different de- 

partments . : . . . . . - 42 
well and aed Pondaated! difference Berween é : : : , . 148 
ate)”. : : , : : : : » . : ey 
amount prayed per ay : “ : : ; ‘ ; : , , Ides 
percent.ofwaterin . : ; ; F : ; ’ , ope bce’ 
Fear, from its depressing effect, cavities disease . “ : : : ° J Avs We 
Feet of pupils should be supported. ‘ A , ; : : ; : a hs 
Fever, bilious, from unhealthy house-sites . : : : 2 ‘ ; : ; 3 
puerperal, disinfection in ‘ - a . 7 Shi Mgteniiabs obra A 
in pe to be puayded pantie : ; : ; ‘ aleitZo 
BCerieun... ; . ‘ ; ; : Pe ENR Pate We ky inant 2S 
disinfection in : F : : : : : ; iia 4 
epidemics of, difficulty of Mea tea : ; : ; : : #0133 
excreta, importance of disinfecting : : : : . : eeeh tie 
incubation, period of . . : : : . . . ‘ unas 
infection from milk : ; : SP iat Ata ee ahah epee ee 
infectious agent attaches to surfaces in room 3 ° : ; Raga Be: 
isolation of patients . - : : . . : : : TESS 
supposition regarding germ of . ; : : : : ° aa eOn 
spread by infected drinking-water : ‘ 3 : ‘ Eh e 
transmission of . : : ° ° ° : . HO SPARE ea iE he 
typhoid . : f AAS OHA SOAIE Cine (eS Diy alae Heel EBS 
disinfection in. ; : . ° : : rer ile eum Tenn i 1 
epidemics from milk . . : . ° . ° : ° i hs5 
excreta, disinfection of . : ; . : : : : é ee 6 o| 
ROG cI eee ay on sine OMGU ERY, ances Way Mei halt iily oh SAG 
unhealthy house-sites . . . . : 3 
infectious material should be ketrered 3 in he ae room . : - 108 
mental depression the predisposing cause . ‘ , : : a 130 
water infected with, easily disinfected , ‘ : ’ : veESD 
spread through . : : . . : emit 2,:095 
ye ow 5 : ‘ : , ; , . ’ : ea ant 20 
" Peltnation” ; ° ° . : : : ° ° : SAREE 

advice regarding . ; : : . ; F ; AY OG) 

assistants, courageous, called for ° : . : shay ME RAN GS #> 
at sea : . . . . ° . . . . : . aA! 
disinfectants in : d , : : ‘ ‘ . ° + RIO ESE 
disinfection in : : : ° . : d : . 2h G to 
of infected shies ; : ° . : ; ; : 2 0423 
epidemics of, usually deliberate . : ; . , : ei Last LOO 
excreta should be disinfected . : ; ; ° . “ ' Ay i i 
how contracted . / : ° : . . ° ° : A ty By 
how to avoid . - : : : ; : : “ : : “30 
intemperance in connection with . : Sr Cor aye yea war htt oN Deeg 
precautions relating to food and personal habits . : “ 4 PED eto) 
supposition regarding germ of ‘ : : ; ° : ° AGA Coss: 
unsanitary conditions in connection with : ° : ; ° 1 EZO 
Filth the pabulum upon which disease-germs thrive . : A A ‘ \ - 102 
Fire, apparatus for factories ; : ; : , : : , 4 : - 146 
as a disinfectant . : ° ‘ : : ede hos vHiLOD 
open, advantages and iaadvantages a ‘ : : ‘ . . F Bnew 
plan to carry off smoke incase of .. ‘ eigriie thar at TUE en yee DZD 
precautions against, in school-houses . Raha s chon 8 i ees ON deity 19, 


“ Fire-drill ” for school children PUGS CNet WORD ART UR TS COR SOLAN Ec | bebe Lok RNY A) 


188 INDEX. 


ey 


Fire-escapes for factories . 
the best e e e e e e e e e 


Fish, per cent. of water in . : ‘ ; > , : : 
remarks on . ; . AN) er ‘ . ° ° . 
value of, as a food : ; F : : : : : 

Floor area toeach pupil . . A : : : 

fire-proofing beneath, recommended in school- ae 
kitchen : ° . ° . ; : . . 3 
Flour, adulteration of . , : : : : . ‘ ‘ 
and meal, care of 3 " : . ; : . ; 
patent cine . - : ; : ‘ ; ° . 
qualities Por good wir 0 jh. heey ute eae ne yeti 
rye, qualities of : : : ° : ° ° ° 

Flush-tanks, how constructed : . : : 

PSOOTRILES. (cy . x ‘ : ; : ‘ , . : 

Foods and food-stuffs . 3 : : , ° . . : 

amount required daily by the average workingman ‘ 
animal : ‘ , ; : ; ° : . : 
classes of . ; : : ; 3 , ; oa 
definition of , ; : . ‘ ‘ ‘ : : 
economic value of . , ; . : ° , . 
must not be left in living or sleeping rooms . . . 
nutritive value of ‘ : : ; ‘ A ; ° 


rations, daily, cheap, without meat; analysis and cost . 
with meat; analysis and cost . : 
moderately cheap; analysis and cost 
more expensive; analysis and cost 

vegetable . ; : ; ° ° ° ° ° ° 


volume of essential . : ° ° . ° . ° 
Food-stuffs, character of . ; : ¢ : s ; 
Fowl, remarks on 4 5 4 ° ‘ ° ° A ° 
Fruits . . ° : ° ‘ 5 Sig ° me . 

canned : : : : . . . : . . 
poisoning bydecomposed . .« «2. « -« 

value of ° : ° . : . : : . $ 
water in, amount of . ; : * 4 4 - 
Fumigation (see sulphur dioxide and sulphurous acid gas) . 
by sulphur pat ee ck S10 te EM BAS ae ‘ 
precautions in . : : : : ‘ ; ‘ 


Furnaces, hot-air, air-chambers should be kept supplied with water 
ductsfor . : ° . . . . ‘ - 


flues, arrangement of . : : : . . . 
how constructed . ° . ° , ° . ° 
registers, position of . . . . . . e 
size of . : ; ‘ . . . : . ° 


ventilation in connection with . ; 5 ; . 
Furniture, disinfection of . - : : ° . e ° 


Gangrene, hospital, to be guarded against ° . ° ° 
Gases from decomposing matters injurious : Stes . 
Gelatine culture medium . ; ° > 3 ° : 
German states, amount of fresh air auled pupils in the . . 
Germicide, a, may act as an antiseptic é ; : : 
Germs, decomposition due to . ; d : Peres Gl 
disease, in the sick-room ; 4 : 4 ‘ 


-| en 
oe 
oo 3S 
¢ ge 
> 39 
a 
ee 
. is 
«ee 
50, 51 
ee 
Saad 
«ge 
aa 
Pe 
ste 
s 26 
» 3g 
» ee 
ee. 
<) eee 
a 
ee 
oem 
<a 
«i eae 
oy eel 
. es 
0 nee 
Pres: 
3 om 
«ae 
ee 
oe 
oa 
Li ee 
117, 136 
112,/tis 
o en 
oon tie 
11, 80 
Ps 
. ee 
° | ee 
ho 
> aan 
- hae 
.: 120 
- og 
3.) foe 
ae 
- 108 
: ee 
~ Hee 


iS 


INDEX. 


Germs, disease, many now known to us ; ; 
may be produced in culture fads : ' : . . 
not charmed away 

filth the pabulum upon which they atts 
the infectious agent of many diseases 

Girls, sickly, in school-room : : - 

Glucose ; ‘ 

Goitre possibly Byitaced by pene hard abe 

Grains and cereals 


Grate, at least one bed-room Mahould contrat Acre ; F ‘ 3 ‘ 
Gravel caused by drinking hard water ; é ; . . ’ . 
Grindstones in factories should be covered “ ; ‘ 4 . ‘ 
Gymnastics and school-desks ’ , : t - ‘ 
how exereised in school-room . : ue 43 : ; ° 
obstacles that prevent, in schools . : ? : : : 
Fi 
Halls for tenement-houses . ; ; 
should be placed on the side of the Henge arias rhe ist hantiaht 
space saved by doing away with ; ; ; : . . 
Ham, pork, and bacon : ; 3 ° é 
Hand-grenades not to be Beoenticd Gaon : : . 
Handkerchiefs, how to disinfect . : : ‘ . : Fi : 
Health, sunlight essential to ; , ; : , : ; : : 
_ Healthy foods - ; : : . ‘ Pe nha ° . : : 
Heating and ventilation. ; HOT SORE Stet) is eae Hut Ce 
BWEMELIYeCE : : : : ‘ e : . ‘ . 
methods of . : - : ; ; : : : ° ‘ 
of factories . - : ; : ; : : ‘ : ° 


Height of school-buildings . ESN ARAN Sei pT Re toe eT 
Hog, value of, as an article of food . ; eee: artis ‘ ‘ 


Home, building a : , : : ; : ; ‘ ° ° : 
care of)... : F : : : : : : ; ‘ . 
location of : : : , d ; ; : ‘ DAug 8 
surroundings of . : : ; ° ; ; ; : : 

Honey . : : . ° 

Hospitals, disinfection, end bine precautions sob bse Riveiee . : 

House, buying or renting a . : ° ‘ ‘ , ‘ 
directions for inspection of a . ; ‘ : x : . . 
floors of, how made . : : : : : . ° 
new brick should not be occupied eoraedetels . . . 
should always have acellar . . ° , : ° . . 
site, best soilfor . A : ; " 2 : 5 : : 

should be drained . ‘ mean ues Bo dicen ts SUA ine 
tenement . : : . . : ° : . . ° 
Hygiene of the eye : ‘ . ° : ° : . . ; 
school . ; j ° : : ° : : ° 
it 

Ice, dangers from ° : : . : . 

Individual prophylaxis against pictus diseaces . . ° ° ° 

Infants, preparation of cows’ milk for ‘ : : : : ° : 

Injuries in workshops . : : . . . : S08 be ° 

Instruments, surgical, diniatetHign of . : - PAL ae tes A keke 

Intemperance and the workingman . ; : : ‘ . : . 


in pestilential diseases . : ° ‘ ; ° . ‘ 


190 INDEX. 


Iron, drinking-water should not contain more than one tenth of one per cent.of . 


sulphate of, an antiseptic . . . : : . : ‘ . : . 
special uses . : : ; : . ; : . . . . 
K 
Kedzie, Prof., on amount of air required for pupils . : : . 4 EH Gily 
Kitchen in basement undesirable , : : ; 5 ° ° : . >. Cae 
the most important room in the house . , ° . . . 7 
to be kept in good order, must be properly conetracted : F . . 7 
windows, there should be at least two on each side . . . . : 7 
Kohn on the eyes of school-children . . .  . oes CaS 
L 

Labarraque’s solution asa disinfectant . .  . .« . | - 0 Ve ie 
special uses of ad Wy BN : , , ; . . ° . LES 
Lamb, easy of digestion ; oe ee is 
Lange’s method of testing for etivosts acd, oa ee | ice Nan 
Latrines, how constructed . t ; y : : . . : 4 ° te 
Lemonade, sulphuric acid, incholera. . . . eo et jo Ve 
Lenses may produce fire. . : ; : . . . . . » 'I4s 
Light, bad, cause of near- Teal A btpa le ‘ ; . . . . : ern 
how it should be admitted to the school-room . : : . ° . >» ae 
in factories : ° : ° ‘ ; . . . « 143 
not sufficient on a ectricted ea : ; 4 ; Mk 
the best for school-rooms . ; : ; : : ° : « 2G 
the most essential thing in a public school 0 0 fa.” 3 
Lights in factories i ; 4 : ‘ A . ‘. “| 3 ; o / TAm 
Lightning-rods_ . . : 3 : . ° . ° ° ° ot 143 
Lime, chloride of, as a digtatertant ‘ 4 ; : ; : ° . : «Ee 
for the sick-room ; ; - ‘ ° ° - eo’ 184 
how prepared for the isiMer Hon of vaults . ° . ° 3 . ute 


special uses of . : ‘ F , : . . PPS ac 116, 118, 119, 120 
Littré’s definition of disinfection . 2 : f “ 4 4 ‘ s a .', 103 
Lobster, value of . : : ; ; ‘ 5 A j : . : 4 . “ow 


Machinery tends to dwarf the intellect 4 ‘ PM Me he ny 153 
Mails, disinfection of . ‘ ; : A 4 . ° ° ° ° ° « 123 


Malaria from unhealthy house sites. q . . . title » ape 3 
Martin, A. C., on amount of air required for paptis ° . ° ° . °.\) ree 
Meal, adulteration Oliva . ‘ : : 5 ° . ° : . . o } VRE 

and flour, care of ‘ : : ; : . ° 0) | ey eae a 50, 51 
Measles : Ayia , ; we he ee ee 


Meat, constituents ie : 3 : : : ; . . . ° . ° | ae 
degree of digestibility : ; 4 : > a wy ne a! Nea 


differs at different seasons . ; ‘ ; . ° ° ° ° o 38 
diseased, produces disease ‘ ° a ° . ° : ° ° (ae 
effect of rigor mortis . ° ; : . : : Rtn tA a . » 35 
extracts . . ; ° . . : . e ° e e e 40 


fluid and pentores e ss : - ; . ; ° ° : ° oy ee 
general properties of . : - ‘ : . . . . ° : o. Lee 
heat necessary to destroy parasites . ‘ . hada : : ° var 
how effected by slaughtering . ; ° 0 IT es 
how to boil aA aw carat ee) aah hie ate Abu as a hepldnl lx clan 


INDEX. 


Meat, howtoroast . Mer ea ie 
in common use . : 
knowledge possessed by re aaclents 
list of, which should not be eaten 
methods of cooking 
parasites of, conveyed to man : i 
partially decomposed, may be poisonous . 
rules to govern the selection of 
some fat desirable in . 
stewed : 
water, amount of, in . 
Mechanics, exposed to lung disease 
the lives of, not what they eeouia be 


Medical attendance, the best, difficult for mechanics oe Siete : 


officer and school officer combined 
Melons . 
Merchandise, Geehfection Of : 
Mercuric chloride, amount required to Bieitect pene 
as a disinfectant 
as an antiseptic 
destructive to spores 
special uses of : ; ° ; 
Mercury, bi-chloride of, as a disinfectant . 
Micrococci i : . ‘ : ‘ : 
pathogenic, destroyed by carbolicacid . : 
Milk . : ; : ; : ; 


e e ° e 


_ absorbs gases : : : ; : : : 
adulteration of . : ° : ; 
amount required to support life ; ‘ ‘ : 
average amount of water in : : ‘ 
“barnyard” . : : ; : ° : : 
“bitter-sweet”  . ; : ; P , : 
“blue ” - ; : , : : 
care of the. . : ‘ : ; 
composition of . ; : : : : : . 
condensed, how prepared . : ; F : 
cows’, preparation of, for infants : P : 
diseased ‘ : é ; “ : ; : : 
germs of disease distributedin . a ack nae 
kinds that should beavoided . } . ; : 
methods of adulteration ‘ : ° : 
precautions regarding use during fepilewnes d : 
scarlet fever conveyedin . , E : : A 
sickness, cause not recognized . ; : é ; 
‘slimy ” ' : ; : ; f ° ° : 
souring of : oh ads : 
sugar’... , 3 ; ; : : : 2 
value of, as a food : ; : , ; . ‘ 
watering, may be a criminal act . : p : : 

Mineral matter contained in bones. 2 ‘ a - 
in muscles, blood, etc. ; 5 ; : 

salts ; : : ; : , : . . 
Molasses and syrups . - ‘ : : : ‘ . 
Moulding-machines, dangerous . : ‘ : : . 
Mustards, how adulterated . F : : : ; : 
Mutton, general remarks on . . : : . . 


Myopia. ‘ . : ; : ‘ ° . : 


. 


115, 116, 118, 119, 120 


° 


192 INDEX. 


N 
Napkins, how to disinfect . : ; : ; Wy hake : . - ‘ 
Naphtha, dangers from , : : ‘ : ° . : . ° . 
Near-sightedness, chief causes of . 4 : : ; ‘ : ‘ . 
disadvantages of . ; ° : 
percentage of, in different Hationultiee : ; : : : 


sometimes inherited 
Nervous system, affections of the ; 
Nichols, Prof. W. R., on carbonic gas in schools 
Nuts, composition of 


O 


Oatmeal, composition of 
qualities of 

Odors, bad, should arouse suspicion 
Oils, etc., should be kept in a fire- Pee building 

vegetable : 
Oleomargarine and batrenne : 
Organisms, micro, difference in reset Api of 
Overwork in the school-room 
Oysters, nutritive value of 


a 


Pantry or shelves should be provide . 
Parkes and DeChaumont, on amount of tresh air sveantreHt in Geboel rooms 
Parlor, how regarded 
Parsnips : : ; ‘ : : ; ; : : : : ; 
Pea sausage . 
Pease and beans 
composition of . 
food value of 
soft, green, easily Hivestedt 
Pepper, how adulterated 
Peptones and fluid meats 
Personal cleanliness among mechanics 
Person, disinfection of the : 
Persons, susceptible, do not always hae aneue , 
Pipes and tanks, lead-lined, should not be used for conveying or ore cca 
water 
Pipes, water, should be ei iron, ploeicun, or Winer with tia 
waste, how arranged . 
Plastering, how put on stone or brick . : 
Poisons, persons working over, should talk but little . 
should be carefully labelled . 
Police, sanitary, general object of ‘ : : A : 
Pork, bacon, and ham . ‘ : ‘ : : ‘ : ; “% 
“ measly,” description of 
rules governing the selection of 
Potatoes, composition of . s : ‘ : . D . : . 
Privies, disinfectants for 
school-house 5 AS ‘ 
cause of disease among Salis 
faults of . : ; ; : . 
should be separate for: the sexes ‘ ; : ‘ 
special dangers from . 


INDEX. 


Privy vaults, amount of mercuric chloride required to disinfect . 


dangerous to health 

disinfection of . : ; 

how disinfected with chloride of ae 
Prophylaxis, general rule of 
Proteids, conversion of 

or albumens . 

Phthisis (see Tuberculosis and Conemmsnant: 
Ptomaines a product of putrefaction 
Pulleys, loose, dangers from 
Pumpkins 


Quarantine establishments, disinfection at . 


Race susceptibility to disease 
Rags, disinfection of : ; F 
oiled, liable to spontaneous eeciination 
transmission of disease by 
Railroading, accidents in 
Registers, hot-air . 
in ventilating Auen icra niaeed. 
size of . 
Residences, how built . 
Rhubarb 
Rice, composition of 


“Roofs should be provided with fenders to ly snow ida LOR. 


Rooms, arrangement of : 
living should be sunny and ee . ‘ 
recitation, deficiency in size. 4 : ° . 

Rules for factories : 7 ; ; ° 

Rye, compositionof .  . A ek: Walt. 


S 
Sago . : : ; . ‘ ; . . . . 
Salt, value of ° ° . NE oe ial Aske Seis 
Sanitary supervision of schools s . Shiba o hes! ate 
Semeeeermamiteration Of i ee 
poisoning . ‘ . : . . 
remarks on . : : ° ° . 
Saws, danger from 
different kinds of ° 
Scarlet fever (see Fever, scarlet). 
Scholars, grievances of ‘ - z 
School architecture, greatly improved igen a a years ‘ 
boards, responsibility of . - : ; ‘ . 


buildings, height of . : : ‘ i ; 
in New York . : : : : ° 


plan and arrangement of ; . : 
children, German, work harder than American. 

harm from social dissipation . : 
class-room, height of ‘ ; ‘ , : : 
desks and gymnastics . ; : : ° : 
fatigue, results of : 2 : 
School-house, city, desirable eet af ne é 


193 


120 
17 
17, 119 
120 
124 
25 
24 


102 


150 


55 


122 


194 INDEX. 


School-house, four-square plan of aes : ; ° . . 
precautions against firein . . . 
without cellar, should have air space pene float 
School hygiene, division of subjects 
officer and medical officer combined 
prizes bad 
room, excessive height a erat 
lack of space a fault 
large, with insufficient light . 
the separate entrances (illustration) 
temperature of : ; ; ; 5 : . 
large, twofold advantage of . 
ventilation of 
sessions, time of 
Schools, contagious diseases in 
medical supervision of : 
regulations to prevent the spread of contapeas liscagee 
sanitary supervision of . 
should be removed from noise 
Seats for school-children 
for factories 
Septiczemia to be guarded against in ne pitts 
Sewerage 
* separate er A i of Xe) called 
Sewers, cause disease among school-children 
grade and position of 
Ships, disinfection of 
by steam : 
should be performed by a ane eee 
how to disinfect the bilge . 
how to treat an infected one in port . 
Sick-room, daily care of 
disinfection of 
should be full of dee 
Sink-traps 
Site of school-house : 
dampness of 
underground water provided for in ; 
Skin, contagious affections of, excluded from schonts! 
diseases . : : : ; 
Small-pox . : 4 : i ; : J ; : is 
avoidance of 
disinfection in 
how contracted 
infectious agent attaches to were Be room 
principle of . 
isolation of patients 
the result of personal habits 
‘respirator ” in, the 
statistics of, among the Givemcnared ss 
supposition regarding germ of 
vaccination the prophylactic 
Soil-pipe, construction of 
Soil, ventilation of 
Soup, how to make 
Spinach 
Spine, deformity a 


INDEX. 


Spittoons with sawdust, the cause of fire 
Sponges, disinfection of ; 
Spores, certain species withstand a Doan temperature 
description of . ‘ 
destruction of, a test of anicceny AaWer 
not destroyed by sulphur dioxide 
power to resist heat and disinfectants 
Sprinklers, automatic, in factories, a protection against fre 
Sputum, how disinfected . 
Squash . 
Stairs, bad. effects Of : 
. spiral, objectionable . 
Stairways should be fire-proof 
Starches . : : 
amount required per day 
and carbo-hydrates 
Steam, disinfection of clothing with 
heating, one of the best methods 
pipes, care of 
under pressure as a Hiunféctant 
Stoves, advantages of coal 
of wood . 
and furnaces, care should be used in ithe A aHeeoRetOn Ag 
cast-iron, emitting carbonic acid gas, belief not sustained 
. how arranged in factories 
. should be covered with.a hood 
. ventilating 
Study, under certain Sere OR ee cause bf near- cerdlteaneasy 
Sugars . : 
Waditeration of. 
quality of . 
Sulphur, amount necessary in Peacaeon 
dioxide, disinfection with . 
precautions in fumigation with 
Sulphurous acid gas (sulphur dioxide), disinfection with 
in the disinfection of ships 
not destructive. to spores 
Sunlight as a contributor to health 
should. not be excluded . 


Syrups and molasses. . : ‘ : : : 
T 
Tannin in tea ; ‘ : : d : : A 
Tapioca , 
Teaastimulant . - 5 ; : . s 7 , t 


how adulterated 
how prepared for Hanning 
increases waste of tissue 
kinds of . 
when to be used 
Teachers, grievances of 
lack of exercise among 
Theine . 


I12, 116, 


The preventable causes the cliseseet ier and AV Aah in merean enero ane 


work-shops, and the best means and appliances for avoiding them 


Tomatoes . : 


123 


ok Fd 
55 


196 INDEX. 


Tools, howto leave . ; : ; : . ° . ° ° oe Uhke - 50 


Towels, how to disinfect . ° . . . : . ° . ° . e II5 
Traps for sinks . : : ‘ ; . ° ‘ MU Hh: 8 <: o., Aca eow 
how placed BL ne SNe Te allo gla ann 
ventilation of . ; : ; ; "| é A ° A ° ° o. Oe 
Frees frequently beneficial. (0. 0 he a Sy 
Trichinz ; ° . ‘ . - . . . Panes: | 


destroved. at ee feees Fane, : : ° : : ; . : $0) 5a 
Trucks for handling goods, how constructed ,. . . |. « | =s0)\i stun nnnnnC 


Tuberculosis . ‘ ° . Pt of ae 
advice to these faviag a eecitary prediepouren tO Rees . a= 136 
an infectious disease 4 . : . . . ° <UL aS 


caused by the inhalation of Huet : ; ‘ ’ > e ° e 335 

difference in susceptibility to . a . . . ° ° ° ot ae 

important to disinfect excretain . . ° : ° . . rue ay: 
Turnips and turnip-tops : ; p ° ° ° ° . ° ° » 54 
Typhoid fever (see Fever, ona 


U 


Urinals, how constructed 2.0. 6 te ie © ele a 


v 


Vaccination . : ‘ ; : ° : ‘ ° . . 6.) lee ie - 132 
should be enforced among school-children . ; ° ° © Mekal ee 
Vaccine virus destroyed by disinfectants .  .° . |. | su)» \)eeeensnn 


destroyed by sulphurous acid gas ° . : : . . Pe & 5°) 

Vallin on disinfection and disinfectants . ; ‘ . A . F > 103 

Vaults, how cared for . ‘ fi . . . ; é ° : . : Nara 

Veal, digestion of, difficult . ; ; A . : , ; : . ; Sain 

general character of . : , : . : ; . . : ey 

rules governing the selection of ° : : . : : : : A Se 

Vegetables . ; ; é : 4 A . . . : , ° ait 54 

amount of ater tans : . * 4 ° ° ° ees 

decaying, must not be left in the eae s : . . : . o tt9 

foods . ; : . . “ 5 ‘ a 4 : . chia 

Ventilating apparatus, Himeneine Obey : ; . . . . : ° a ihe 
by steam power ; ; : : ° . . . : ° PO gs 

devices for windows . { : ayo hite : a ake Kae 8 

flues should have air-tight jae . : ; ; : : . oie a 

should be one foreach room . : : ° , : Pana) i 

Ventilating-stoves ; EAT Arie ee LAE 4 Tie oh adh alr 

Ventilation and heating ; : : 4 2 ‘ : ‘ : : t peek: 

by means of flues : : ; : ° : . 9 

by means of tube fermninaning in ovedatlet : : ‘ ; : 9 

good, a low temperature more comfortable with than without : hy 

what it implies d ‘ ‘ A : ; : ; Oe Hite 

in connection with hot-air fernites : : ; i . ; . Nae 

stoves . 4 ; 4 ; : : : : Siva: 

in factories : ; . ; ; : 4 : : ; tee 

in school-rooms : ; , ‘ ; : : ‘ : : oi ae 

methods of ‘ ‘ A ‘ 8 : ; 4 : : Ra 

of tenement-houses . : " : ‘ ‘ : : ‘ ‘ a ee 

oftraps .. 3 Ue oe 

system used in the Niassacinabees Fastitate of Techuoteey : , Alea | 

Ventilator, open fire an excellent i ; ; ; t " : : ‘ : 6 


the “ Eureka” . : ener : ; ak : oye ae ee 


INDEX. 197 


Vinegar, composition of 


eee ah 4 ed fbi patas a USE PERO 
varieties of . : : 2 é : é ° . : . ° ont 80 
Virchow on “ School Diseases ”’ : } e . : whe G5 
WwW 
Wall-papers, economy of ; ; ,. ‘ ; . 5 
frequently contain arsenic : ; ° ; ° : ° ° : 5 
Walls, tints of, for school-room . ; : : . . ‘ « O2 
Waring, Col., method of paris Hee. ae Root ; : : , : a.) 
Waste, disposal of : : ‘ : : ; ° ; : ‘ Batis 
kitchen, how ienoued of . : ‘ ; ; : y s 2 ; pie $ ¢:) 
pipes should be well ae , ; ‘ ; : ; ; : q Sali 
Water absorbed by brick. : : . : : d : ; . ; 5 
cistern, defined . é : cat ; : ; : i q Be ee 
how contaminated : : : : : : ; : : Suse 
filters for : : : : eas 
lead pipes or lead-lined Eiprae: Btaules should not ibe one : : Spey tag 
containing disease-germs ne disinfected . : , 4 : aie ad 
disinfection of ; eee oe 
drinking, should not pene more ethan one geitin gh one Rey peat 
Ofaron:, |)’. ‘ : ‘ : ; : : ; , : Wei ba wi 
sources of . : : é : : 7 3 Pe bid &. 
evaporation of, in connection with eaters : - : : ! rey ete 
hard, classification of . : : ‘ : ; : : : gant 
diseases caused by ; ‘ ° : ° ; ° ° Shiv tA 
hardness of, due to inorganic salts : ‘ : ‘ Bal « 1 A. 
impure, diseases spread by . : ; ; . ° ‘ : Pied £3 
per cent., in adult body > . : ‘ eras 
pipes, discharge, how cons.ucted in eens Raaees : . Las 
public supply, health authorities should see that it is pure ‘ ie it Bt 
subterranean, often hard ' ; ‘ ; ; é Pant ¥ 
surface, should be boiled in times of opeenics ; : } : aes 


the purity of, dependent upon the soil and air : ; Py he: 
typhoid fever and dysentery spread by . ; : : eS 
to what extent purified by filtering through the soil . ; : ea tt 


Water-closets, amount of water required in ‘ ; , : : A : eeeres 
dangers from : : : : : . : : 2 : +. 242 

for schools . : ‘ : : , : ; ° ; 71, 84 

hopper, arrangement of . RON A ee kane bal ir Pee, We Ne 6 

how arranged ‘ : : ; ; : : é ; stu kag 

how cared for in tenement- hinges : : 4 PO Me bY 

Wells, deep, should have their walls protected against ec aaicn ; ; Cop og ak 
in village or city should be avoided Sian ba ; SIEM Sida da) ators 38 
shallow. ‘ : ; : ‘ ‘ F } : : : ; ued 
Wheat, composition of Are sinkee : : AEN Se PLE SNe peas OEE Sr NEEL. Fo 
Whooping-cough C1 oa ate AS pct SERCO MEM cA a Rha Rate. Wee ell Rae 
important to disinfect excretain . ‘ : : : . Aid et 

Windows, cellar, how arranged . ; ‘ : - , : : : ; ‘ 4 
draughts from, the cause of sickness : SUSU Ay ihe FUN re eae 

should be at least two on each side of the halle . ° ; . Aye 

light from, in school-rooms aye PNMINe Ea Peh amet saya tact his? a OE 

opening, regarded in two lights : , ‘ BAe OP Meh Hy Wee 

position of, and how hung . , ; . ! . : ° ‘ ; 7 

space to school-room . ° . ° . : . : : . ee 


Worms, tape, developed from cysticerci . : : ‘ , ; ‘ : unaso 
Wounds, importance of antiseptic treatment in . : ; ; ° ° . {ykt20 


Yards, cleanliness or. 


7% eR. 


Yeast, 


factory, should be kept clean of rubbish . 
composition of . 


: Yellow fever (see Fever, yellow) ip 

roe ‘. ee ‘ : 7, 

Zine, chloride of, as a ina ert, SHS ISH Palle 
in cholera 


over-estimated as a disinfectant 


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